Castelein Stynke, Visser Ellen, Brilman Maarten F, Wardenaar Klaas J, Bruins Jojanneke
Lentis Psychiatric Institute, Lentis Research, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands; GGZ Drenthe Mental Health Institution, Department of Psychotic Disorders, Dennenweg 9, 9404 LA, Assen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Psychosis Department, Hanzeplein 1 (CC60), 9713 GZ, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1 (CC72), 9713 GZ, Groningen, the Netherlands.
Compr Psychiatry. 2025 Jan;136:152540. doi: 10.1016/j.comppsych.2024.152540. Epub 2024 Oct 28.
Most studies on recovery of psychotic disorders focus on first-episode populations using premorbid and baseline data to predict recovery. However, many patients experience a long duration of illness and many factors are dynamic and change during life.
To investigate factors strongest associated with clinical, societal and personal recovery, and recovery change scores in people with a long duration of illness using current data measured at the same assessment.
Least absolute shrinkage and selection operator regression analyses with cross-validation were used to identify the correlates of (changes in) clinical (N = 1054), societal (N = 1145) and personal recovery (N = 1187) in people with psychotic disorders. Subsequently, the identified associated factors were included in separate linear regression models, examining the associative strength of the identified variables and overall fit of the models.
Better clinical recovery was associated with better societal and personal recovery, experiencing fewer problems with daily functioning and social relations. Participants had a better societal recovery when they were employed, had fewer problems in daily life, less negative symptoms, had a life partner and better clinical recovery. Personal recovery was associated with greater satisfaction with life in general, no depressive mood and increased clinical recovery. Change scores were small with minimal fluctuation and no significant associations with change scores were detected.
Recovery domains strongly influence each other in people with a long illness duration of psychosis and should therefore have an equally important focus during treatment.
大多数关于精神障碍康复的研究都聚焦于首发患者群体，利用病前和基线数据来预测康复情况。然而，许多患者病程较长，且许多因素是动态变化的，会在生活过程中发生改变。
利用在同一评估中测量的当前数据，调查与病程较长的患者的临床、社会和个人康复以及康复变化分数关联最强的因素。
采用带有交叉验证的最小绝对收缩和选择算子回归分析，来确定精神障碍患者临床康复（N = 1054）、社会康复（N = 1145）和个人康复（N = 1187）（及其变化）的相关因素。随后，将识别出的相关因素纳入单独的线性回归模型，检验所识别变量的关联强度和模型的整体拟合度。
更好的临床康复与更好的社会和个人康复相关，日常生活功能和社会关系方面的问题更少。参与者在就业、日常生活问题较少、阴性症状较少、有生活伴侣且临床康复较好时，社会康复情况更好。个人康复与总体生活满意度更高、无抑郁情绪以及临床康复改善相关。变化分数较小，波动极小，且未检测到与变化分数有显著关联。
在病程较长的精神病患者中，康复领域之间相互影响强烈，因此在治疗过程中应给予同等重要的关注。
