Characterizing psychosis risk traits in Africa: A longitudinal study of Kenyan adolescents
Characterizing psychosis risk traits in Africa: A longitudinal study of Kenyan adolescents
复制标题
DOI：
10.1016/j.schres.2016.08.004
复制
发表时间：
2016-10-01
影响因子：
4.5
通讯作者：
Ndetei, David M.
中科院分区：
文献类型：
--
作者：
Mamah, Daniel;Musau, Abednego;Ndetei, David M.
精神分裂症的前驱症状在非洲还没有得到广泛的研究。前驱行为症状的识别为早期干预和预防疾病的发生提供了希望。我们的目标是调查肯尼亚青少年的精神分裂症风险特征，并确定精神病进展的预测因素。使用精神病风险综合征(SiPS)的结构化访谈和华盛顿早期识别中心情感和精神病(WERCAP)筛查，从肯尼亚马查科斯的中学生中识别出135名高危(HR)和142名低风险(LR)青少年。比较了不同组的临床特征，并对参与者进行了0、4、7、14和20个月的纵向随访。使用多元回归分析研究了精神病转化和严重程度变化的潜在预测因素。与LR参与者相比，HR组观察到更多的精神合并症和增加的心理社会压力。人力资源参与者的注意力也更差，而抽象力更好。精神病转换率为3.8%，只有基线时沟通障碍的严重程度才能预测转化率(p=0.007)。在研究期间，HR和LR参与者的精神症状严重程度均有所降低。ADHD、双相情感障碍和严重抑郁症的诊断，以及较差的职业功能和精神分裂是精神病严重程度改善较小的因素。我们的结果表明，在肯尼亚HR青少年中，精神病理和残疾的发生率相对较高。很少有精神病转化可能反映转化时间不足，需要更长时间的后续研究来澄清风险预测因素。确定无组织的沟通和其他风险因素可能有助于为肯尼亚的人力资源青年制定预防战略。(C)2016年提交人。爱思唯尔出版公司(Elsevier B.V.)
The schizophrenia prodrome has not been extensively studied in Africa. Identification of prodromal behavioral symptoms holds promise for early intervention and prevention of disorder onset. Our goal was to investigate schizophrenia risk traits in Kenyan adolescents and identify predictors of psychosis progression.135 high-risk (HR) and 142 low-risk (LR) adolescents were identified from among secondary school students in Machakos, Kenya, using the structured interview of psychosis-risk syndromes (SIPS) and the Washington early recognition center affectivity and psychosis (WERCAP) screen. Clinical characteristics were compared across groups, and participants followed longitudinally over 0-, 4-, 7-, 14- and 20-months. Potential predictors of psychosis conversion and severity change were studied using multiple regression analyses.More psychiatric comorbidities and increased psychosocial stress were observed in HR compared to LR participants. HR participants also had worse attention and better abstraction. The psychosis conversion rate was 3.8%, with only disorganized communication severity at baseline predicting conversion (p=0.007). Decreasing psychotic symptom severity over the study period was observed in both HR and LR participants. ADHD, bipolar disorder, and major depression diagnoses, as well as poor occupational functioning and avolition were factors relating to lesser improvement in psychosis severity.Our results indicate that psychopathology and disability occur at relatively high rates in Kenyan HR adolescents. Few psychosis conversions may reflect an inadequate time to conversion, warranting longer follow-up studies to clarify risk predictors. Identifying disorganized communication and other risk factors could be useful for developing preventive strategies for HR youth in Kenya. (C) 2016 The Authors. Published by Elsevier B.V.