Untreated initial psychosis: Its relation to quality of life and symptom remission in first-episode schizophrenia
Untreated initial psychosis: Its relation to quality of life and symptom remission in first-episode schizophrenia
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DOI：
10.1176/appi.ajp.157.5.808
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发表时间：
2000-05-01
影响因子：
17.7
通讯作者：
Miller, D
中科院分区：
文献类型：
--
作者：
Ho, BC;Andreasen, NC;Miller, D
目的：先前的研究表明，精神分裂症患者未经治疗的精神病持续时间较长与预后不良之间可能存在关联。这些研究被解释为提供了证据，证明未经治疗的精神病可能构成一种对大脑“有毒”的“活跃的病态过程”。如果未经治疗的精神病是神经毒性的，这将形成一个强有力的基础，早期干预schizophrenia.Method：74例抗精神病药初治患者与DSM-IV精神分裂症进行了评估6个月后，他们的第一次住院治疗。作者研究了未经治疗的初始精神病持续时间（从第一个症状发作以及从完全阳性综合征的发病）和生活质量，症状严重程度和缓解阳性症状的时间之间的关系：发病年龄较早与未经治疗的前驱精神病症状的持续时间较长。未治疗的初始精神病的持续时间没有显着的性别差异，也没有任何显着的关联未治疗的初始精神病的持续时间和病前功能。在控制发病年龄的影响后，未治疗的初始精神病的持续时间并没有显着损害随后的生活质量，症状严重程度，或缓解阳性symptoms.Conclusions：未治疗的初始精神病的持续时间不：预后不良的结果早期精神分裂症的过程中。需要对神经毒性进行生物学测量，以更直接地检验“毒性精神病”假说。
Objective: Previous studies have suggested that there may be an association between longer duration of untreated psychosis and poor outcome in schizophrenia. These studies have been interpreted as providing evidence that untreated psychosis may constitute an "active morbid process" that is "toxic" to the brain. If untreated psychosis is neurotoxic, this would form a strong basis for early intervention in schizophrenia.Method: Seventy-four neuroleptic-naive patients with DSM-IV schizophrenia were evaluated 6 months after their first inpatient hospitalization. The authors examined the relationship between untreated initial psychosis duration (measured from onset of fi rst symptom as well as from onset of full positive syndrome) and quality of life, symptom severity, and time to remission of positive symptoms.Results: Earlier age at illness onset was associated with longer duration of untreated prodromal psychotic symptoms. There were no significant gender differences in duration of untreated initial psychosis, nor were there any significant associations between untreated initial psychosis duration and premorbid functioning. After controlling for the effects of age at onset, the duration of untreated initial psychosis did not significantly impair subsequent quality of life, symptom severity, or remission of positive symptoms.Conclusions: Duration of untreated initial psychosis was not: prognostic of poor outcome early in the course of schizophrenia. Biological measures of neurotoxicity are needed to examine the "toxic psychosis" hypothesis more directly.