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[青少年分裂情感性精神病的随访]

[Follow-up of schizoaffective psychoses in adolescence].

作者信息

Schmidt M H, Schultz E, Blanz B, Lay B

机构信息

Kinder- und Jugendpsychiatrische Klinik, Zentralinstitut für Seelische Gesundheit, Mannheim.

出版信息

Z Kinder Jugendpsychiatr. 1994 Dec;22(4):253-61.

PMID:7856321
Abstract

Of 156 adolescent inpatients with psychotic disorders (ICD-9: 295.0 to 296.9), 25 had a schizoaffective psychosis with onset before age 18. Of these, 21 were followed up an average of 6.5 years later. Six of the subjects had had only one schizoaffective episode and 15 had had a second episode an average of 14 months later. Half of the subjects had had schizoaffective episodes only. More of the patients with an initial affective episode developed schizoaffective psychosis than of those with an initial schizophrenic episode. On average there had been 0.91 episodes per year during the follow-up period. Seventy-one percent of the subjects had been unable to continue their education or work at the previous level and most had marked deficits in social adaptation. The level of social competence at the end of the first episode was of predictive value for the later social handicap. A comparison with other groups of patients of the same age showed that those with affective disorders had faired better and those with schizophrenia appeared to have the poorest outcome. The schizoaffective group tended to resemble the schizophrenic group more closely than the affective group. Patients whose schizoaffective disorder began in adulthood had fewer problems on the educational and occupational level, better social adaptation and fewer episodes per year and had spent less time in inpatient treatment than those whose disorder had begun before age 18.

摘要

在156名患有精神障碍的青少年住院患者(国际疾病分类第九版:295.0至296.9)中,25名患有精神分裂症性精神病,发病年龄在18岁之前。其中,21名患者在平均6.5年后接受了随访。6名受试者仅经历过一次精神分裂症性发作,15名受试者在平均14个月后经历了第二次发作。一半的受试者仅经历过精神分裂症性发作。初始发作是情感性发作的患者比初始发作是精神分裂症性发作的患者更容易发展为精神分裂症性精神病。在随访期间,平均每年发作0.91次。71%的受试者无法继续接受教育或维持之前的工作水平,大多数人在社会适应方面存在明显缺陷。首次发作结束时的社会能力水平对后期的社会障碍具有预测价值。与其他同龄患者组的比较表明,患有情感障碍的患者情况较好,而患有精神分裂症的患者似乎预后最差。精神分裂症性组比情感性组更倾向于与精神分裂症组相似。精神分裂症性障碍在成年期开始的患者在教育和职业层面上的问题较少,社会适应更好,每年发作次数较少,住院治疗时间也比那些在18岁之前发病的患者少。

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