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早期精神病中基本自我障碍的神经现象学:超高风险样本中与临床结局的关联。

The neurophenomenology of basic self-disturbance in early psychosis: Association with clinical outcome in an ultra-high risk sample.

作者信息

Barata Vera A, Lavoie Suzie, Gawęda Łukasz, Li Emily, Sass Louis A, Koren Danny, McGorry Patrick D, Jack Bradley N, Parnas Josef, Polari Andrea, Allott Kelly, Hartmann Jessica A, Krcmar Marija, Rasmussen Andreas R, Whitford Thomas J, Wannan Cassandra Mj, Nelson Barnaby

机构信息

Department of Psychiatry, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.

Centre for Youth Mental Health, The University of Melbourne, Australia.

出版信息

Australas Psychiatry. 2025 Aug;33(4):736-741. doi: 10.1177/10398562251346619. Epub 2025 Jun 4.

Abstract

IntroductionWe previously proposed a neurophenomenological model of schizophrenia, linking basic self-disturbance with neural deficits of source monitoring and aberrant salience. Baseline comparisons in ultra-high risk (UHR) and first-episode psychosis (FEP) samples indicated a relationship between basic self-disturbance and source monitoring deficits, but not aberrant salience. The current paper reports on the 12-month follow-up results in the UHR group ( = 43), focusing on the association between baseline variables and clinical outcomes.MethodsOne-way ANOVA compared UHR-remitters ( = 18), UHR-persistent/transitioned to psychosis cases ( = 25) and FEP ( = 38) groups on baseline clinical and neuro-measures. Logistic regression assessed the baseline variables' predictive power for UHR outcomes.ResultsHigher baseline self-disturbance scores (EASE total) were found in the UHR persistence/transition and FEP groups compared to the UHR-remission group, and predicted worse UHR clinical outcomes. Source monitoring deficits were higher in FEP individuals compared to those with UHR persistence/transition.ConclusionHigh levels of basic self-disturbance may be a useful predictor marker of poor prognosis in UHR patients.

摘要

引言

我们之前提出了一种精神分裂症的神经现象学模型,将基本自我障碍与源监测的神经缺陷及异常显著性联系起来。超高风险(UHR)和首发精神病(FEP)样本的基线比较表明,基本自我障碍与源监测缺陷之间存在关联,但与异常显著性无关。本文报告了UHR组(n = 43)的12个月随访结果,重点关注基线变量与临床结局之间的关联。

方法

单向方差分析比较了UHR缓解者(n = 18)、UHR持续/转变为精神病病例(n = 25)和FEP(n = 38)组在基线临床和神经测量方面的情况。逻辑回归评估了基线变量对UHR结局的预测能力。

结果

与UHR缓解组相比,UHR持续/转变组和FEP组的基线自我障碍得分(EASE总分)更高,且预测UHR临床结局更差。FEP个体的源监测缺陷高于UHR持续/转变个体。

结论

高水平的基本自我障碍可能是UHR患者预后不良的一个有用预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcc3/12314207/f987a0237a92/10.1177_10398562251346619-fig1.jpg

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