High remission rates from an initial ultra-high risk state for psychosis
High remission rates from an initial ultra-high risk state for psychosis
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DOI：
10.1016/j.schres.2009.10.001
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发表时间：
2010-02-01
影响因子：
4.5
通讯作者：
Umbricht, Daniel
中科院分区：
文献类型：
--
作者：
Simon, Andor E.;Umbricht, Daniel
目的：调查采用前驱症状量表（SOPS）初步确定为符合精神病超高风险（UHR）标准的患者在一年后完全缓解的比例。方法：本研究包括72例14至40岁的患者，他们被转介到瑞士Bruderholz早期精神病门诊服务，并符合UHR标准。在1年的随访中，有52例患者的数据可用。向精神病过渡的患者和持续UHR标准的患者被定义为“病例”，从UHR标准缓解的患者被定义为“非病例”。我们比较了两组患者在基线时的临床和社会人口学特征。结果：13.5%的患者在一年内转变为全面精神病，四分之一的患者表现出持续的UHR标准，59.2%的患者从最初的UHR状态完全缓解。结果与药物或治疗状态无关。在基线时，“病例”和“非病例”在社会人口统计学和临床变量上没有显著差异。结论：在建立UHR状态的一年内，缓解到无风险状态的机会比转化为精神病的机会高出四倍以上。我们的数据强调，通常用于识别UHR患者的症状通常是短暂的，可能无法捕捉到发展为精神病的稳定核心。这突出了在被错误贴上标签的个体中引发焦虑和污名化的危险，并忽略了那些表现出精神病核心特征，但尚未或可能永远不会表现出阳性症状的真正高危患者。(C) 2009 Elsevier B.V.版权所有
Objective: To investigate the proportion of patients among subjects initially identified as fulfilling the ultra-high risk (UHR) criteria for psychosis using the Scale of Prodromal Symptoms (SOPS) who fully remitted after one year.Method: Seventy-two patients between 14 and 40 years who were referred to the Bruderholz Early Psychosis Outpatient Service in Switzerland and who met UHR criteria were included in the present study. At 1-year follow-up, data for 52 patients were available. Patients with transition to psychosis and patients with sustained UHR criteria were defined as 'cases', and patients with remission from UHR criteria as 'non-cases'. We compared clinical and socio-demographic characteristics between these two patient groups at baseline.Results: 13.5% of the patients converted to full-blown psychosis within one year, one quarter displayed sustained UHR criteria, and 59.2% of the patients fully remitted from the initial UHR status. Outcome was independent of medication or treatment status. 'Cases' and 'non-cases' did not differ significantly on socio-demographic and clinical variables at baseline.Conclusions: The chance of remission to a non-risk state was over fourfold higher than the chance of conversion to psychosis within a year of establishing UHR status. Our data underline that the commonly used symptoms to identify UHR patients are often transitory and may not capture the stable core of developing psychosis. This highlights the danger of provoking anxiety and stigmatization in mislabeled individuals and missing true at-risk patients who present features of the psychosis core, but who do not yet-or maybe never will-manifest positive symptoms. (C) 2009 Elsevier B.V. All rights reserved.