Yung A R, McGorry P D
Centre for Young People's Mental Health, Parkville, Victoria, Australia.
Aust N Z J Psychiatry. 1996 Oct;30(5):587-99. doi: 10.3109/00048679609062654.
This study aimed to describe in detail, using a retrospective approach, the prodromal symptoms in first-episode psychosis patients. This initial prodrome, the period of disturbance preceding a first psychotic episode, is potentially important for early intervention, identification of biological markers, and understanding the process of becoming psychotic.
A consecutive series of 21 first-episode patients was recruited from the Early Psychosis Prevention and Intervention Centre, a specialised service for young people aged between 16 and 30 with first-episode psychosis. Subjects were interviewed in the recovery phase after the acute episode, about the period leading up to the psychosis, using a combination of unstructured and semi-structured techniques.
A wide variability of phenomena and sequence patterns was found, with symptoms being a mixture of attenuated psychotic symptoms, neurotic and mood-related symptoms, and behavioural changes. Symptoms were often disabling and some, such as suicidal thoughts, potentially life-threatening.
The findings highlight the loss of information that has resulted from disregarding early phenomenological studies of the psychotic prodrome and instead focussing on behavioural features. The ground work has been laid for the development of better methodologies for assessing and measuring first psychotic prodromes with increased emphasis on experiential phenomena. This has the potential to lead to the early recognition and more accurate prediction of subsequent psychosis, as well as a deeper understanding of the neurobiology of the onset of psychotic disorder.
本研究旨在采用回顾性方法详细描述首发精神病患者的前驱症状。这一初始前驱期，即首次精神病发作前的紊乱时期，对于早期干预、生物标志物的识别以及理解精神病化过程可能具有重要意义。
从早期精神病预防与干预中心连续招募了21例首发患者，该中心是为16至30岁患有首发精神病的年轻人提供的专门服务机构。在急性发作后的康复阶段，采用非结构化和半结构化技术相结合的方式，对受试者进行访谈，询问精神病发作前的时期。
发现现象和序列模式存在广泛差异，症状包括减弱的精神病性症状、神经症性和情绪相关症状以及行为改变的混合。症状往往使人丧失能力，有些症状，如自杀念头，可能危及生命。
研究结果凸显了忽视精神病前驱期早期现象学研究而专注于行为特征所导致的信息缺失。已经为开发更好的评估和测量首次精神病前驱期的方法奠定了基础，更加注重体验现象。这有可能导致对后续精神病的早期识别和更准确的预测，以及对精神病性障碍发病神经生物学的更深入理解。
