Psychosis prediction: 12-month follow up of a high-risk ("prodromal") group
Psychosis prediction: 12-month follow up of a high-risk ("prodromal") group
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DOI：
10.1016/s0920-9964(02)00167-6
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发表时间：
2003-03-01
影响因子：
4.5
通讯作者：
McGorry, PD
中科院分区：
文献类型：
--
作者：
Yung, AR;Phillips, LJ;McGorry, PD
对精神分裂症和相关精神病的前驱阶段的干预可能会导致某些个体的精神病发作的减弱、延迟甚至预防，然而，前驱症状由于其非特异性症状而很难被前瞻性地识别。这项研究的目的是招募和跟踪有向精神病过渡的高风险的受试者，目的是检验某些精神状态和疾病变量对精神病发病的预测能力。对有精神病家族史、分裂型人格障碍、阈值以下精神病症状或短暂的暂时性精神病症状的有症状个体进行评估，并每月随访12个月或直到精神病发作。49名受试者中有20名(40.8%)在12个月内发展为精神障碍。一些高度显著的精神病预测因子被发现：前驱症状持续时间长，进食时功能低下，轻度精神病症状，抑郁和组织紊乱。结合一些预测变量，在6个月内预测精神病的灵敏度(86%)、特异度(91%)、阳性预测值(80%)和阴性预测值(94%)都很好。这项研究表明，在相对较短的随访期内，招募和跟踪具有超高精神病风险的个人是可能的。尽管数字很低，但仍发现了一些对精神病有高度显着性预测作用的因素。这些发现支持针对一些精神分裂症超高风险个体的前驱阶段制定更具体的预防策略，(C)2002年爱思唯尔科学公司。保留所有权利。
Intervention in the prodromal phase of schizophrenia and related psychoses may result in attenuation, delay or even prevention of the onset of psychosis in some individuals, However, a "prodrome" is difficult to recognise prospectively because of its nonspecific symptoms. This study set out to recruit and follow up subjects at high risk of transition to psychosis with the aim of examining the predictive power for psychosis onset of certain mental state and illness variables. Symptomatic individuals with either a family history of psychotic disorder, schizotypal personality disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were assessed and followed up monthly for 12 months or until psychosis onset. Twenty of 49 subjects (40.8%) developed a psychotic disorder within 12 months. Some highly significant predictors of psychosis were found: long duration of prodromal symptoms, poor functioning at intake, low-grade psychotic symptoms, depression and disorganization. Combining some predictive variables yielded a strategy for psychosis prediction with good sensitivity (86%), specificity (91%) positive predictive value (80%) and negative predictive value (94%) within 6 months. This study illustrates that it is possible to recruit and follow up individuals at ultra high risk of developing psychosis within a relatively brief follow-up period. Despite low numbers some highly significant predictors of psychosis were found. The findings support the development of more specific preventive strategies targeting the prodromal phase for some individuals at ultra high risk of schizophrenia, (C) 2002 Elsevier Science B.V. All rights reserved.