Treatment resistant schizophrenia is associated with the worst community functioning among severely-ill highly-disabling psychiatric conditions and is the most relevant predictor of poorer achievements in functional milestones
Treatment resistant schizophrenia is associated with the worst community functioning among severely-ill highly-disabling psychiatric conditions and is the most relevant predictor of poorer achievements in functional milestones
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DOI：
10.1016/j.pnpbp.2015.08.010
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发表时间：
2016-02-04
影响因子：
5.6
通讯作者：
de Bartolomeis, Andrea
中科院分区：
文献类型：
--
作者：
Iasevoli, Felice;Giordano, Sara;de Bartolomeis, Andrea
这项工作的目的是比较高度致残精神疾病的社区功能里程碑方面的成就，包括难治性精神分裂症（TRS）、精神分裂症（对抗精神病药物有反应）、双相情感障碍和焦虑/抑郁疾病。此外，我们调查了几个领域的社区功能结果的预测因素。在连续筛选的患者中，188例符合纳入标准，118例最终进入研究。TRS的诊断采用严格的标准，包括历史和前景评估，并排除潜在的混杂因素。记录日常生活功能里程碑的成就。在离散认知任务中的表现被评估。采用正、负症候量表、个人与社会表现量表、药物态度量表-10和生活质量享受与满意度问卷。TRS患者在诊断组中表现出最高的社区功能损害。与所有其他组相比，TRS有更严重的精神病理，更多的认知功能受损和更差的社会心理适应。在整个样本中，社区功能的主要预测因子是诊断组（TRS诊断与最差功能相关）和其他功能里程碑的成就。然而，在精神病患者中，社区功能的主要预测因子是临床和精神病理变量。这些结果可能支持TRS代表一种独立的精神分裂症亚型的假设，具有自己的神经生物学、精神病理学和临床病程。我们的结果确定了一组可修改的预测因子，以防止社区残疾。(C) 2015爱思唯尔公司版权所有。
The aim of this work was to compare achievements in milestones of community functioning in highly disabling psychiatric conditions, including treatment resistant schizophrenia (TRS), schizophrenia (responsive to antipsychotics), bipolar disorder, and anxiety/depressive diseases. Also, we investigated the predictors of community functioning outcomes across several domains.Among consecutive patients screened, 188 met inclusion criteria and 118 ultimately entered the study. Diagnosis of TRS was made by stringent criteria, including historic and perspective evaluations and excluding potential confounding factors. Achievements in functional milestones of everyday living were recorded. Performances in discrete cognitive tasks were assessed. The Positive and Negative Syndrome Scale, the Personal and Social Performance Scale, the Drug Attitude Inventory-10, and the Quality of Life Enjoyment and Satisfaction Questionnaire were administered.TRS patients showed the highest impairment in community functioning among diagnostic groups. TRS was found to have more severe psychopathology, more impaired cognitive functioning, and poorer psychosocial adjustment compared to all the other groups. In the whole sample, the main predictors of community functioning were the diagnostic group (with TRS diagnosis associated with worst functioning) and achievements in the other functional milestones. In psychotic patients, however, the main predictors of community functioning were clinical and psychopathological variables.These results may support the hypothesis that TRS represents a separate schizophrenia subtype, with its own neurobiology, psychopathology and clinical course. Our results identify a group of modifiable predictors to be addressed to prevent community disability. (C) 2015 Elsevier Inc. All rights reserved.