Negative Symptoms in Early-Onset Psychosis and Their Association With Antipsychotic Treatment Failure.
Negative Symptoms in Early-Onset Psychosis and Their Association With Antipsychotic Treatment Failure.
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DOI：
10.1093/schbul/sbx197
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发表时间：
2019-01-01
影响因子：
6.6
通讯作者：
Pina-Camacho L
中科院分区：
文献类型：
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作者：
Downs J;Dean H;Lechler S;Sears N;Patel R;Shetty H;Hotopf M;Ford T;Kyriakopoulos M;Diaz-Caneja CM;Arango C;MacCabe JH;Hayes RD;Pina-Camacho L
早发性精神病(EOP)首发时阴性症状(NS)的发生率及其对精神病预后的影响尚不清楚。在638名患有EOP的儿童(年龄10-17岁，51%为男性)的样本中，我们评估了(1)NS在首次出现在精神卫生服务机构时的患病率，以及(2)NS是否预测在18岁之前最终发展为多重治疗失败(MTF)(通过启动第三次新型抗精神病药物试验，因为先前的反应不足、无法忍受的不良反应或不坚持治疗)。数据是从英国伦敦南部儿童住院和社区服务机构持有的电子健康记录中提取的。自然语言处理工具被用来测量Marder因子NS的存在和抗精神病药物的使用。用COX回归分析≥2 NS患者的临床表现与5年内MTF发展的关系。在638名儿童中，37.5%的儿童首次出现≥-2 NS，124例(19.3%)在18岁之前出现MTF。在控制了包括精神病诊断分类、阳性症状、合并抑郁和精神病家族史在内的一些潜在混杂因素后，首次发病的NS与MTF显著相关(调整后的危险比为1.62，95%可信区间为1.07~2.46；P=0.02)。与MTF相关的其他因素包括共病的自闭症谱系障碍、首次出现时的年龄较大、黑人种族和精神病家族史。在EOP中，首发的NS很普遍，可能有助于识别对抗精神病药物反应差的风险较高的儿童子集。
The prevalence of negative symptoms (NS) at first episode of early-onset psychosis (EOP), and their effect on psychosis prognosis is unclear. In a sample of 638 children with EOP (aged 10–17 y, 51% male), we assessed (1) the prevalence of NS at first presentation to mental health services and (2) whether NS predicted eventual development of multiple treatment failure (MTF) prior to the age of 18 (defined by initiation of a third trial of novel antipsychotic due to prior insufficient response, intolerable adverse-effects or non-adherence). Data were extracted from the electronic health records held by child inpatient and community-based services in South London, United Kingdom. Natural Language Processing tools were used to measure the presence of Marder Factor NS and antipsychotic use. The association between presenting with ≥2 NS and the development of MTF over a 5-year period was modeled using Cox regression. Out of the 638 children, 37.5% showed ≥2 NS at first presentation, and 124 (19.3%) developed MTF prior to the age of 18. The presence of NS at first episode was significantly associated with MTF (adjusted hazard ratio 1.62, 95% CI 1.07–2.46; P = .02) after controlling for a number of potential confounders including psychosis diagnostic classification, positive symptoms, comorbid depression, and family history of psychosis. Other factors associated with MTF included comorbid autism spectrum disorder, older age at first presentation, Black ethnicity, and family history of psychosis. In EOP, NS at first episode are prevalent and may help identify a subset of children at higher risk of responding poorly to antipsychotics.
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影响因子：
4.3
作者：
Cunningham H;Tablan V;Roberts A;Bontcheva K
通讯作者：
Bontcheva K
影响因子：
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Grobbee, Diederick E.
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通讯作者：
Stewart, Robert
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作者：
Kirkpatrick, B;Buchanan, RW;Carpenter, WT
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Carpenter, WT