Symptomatic and functional recovery from a first episode of schizophrenia or Schizoaffective disorder
Symptomatic and functional recovery from a first episode of schizophrenia or Schizoaffective disorder
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DOI：
10.1176/appi.ajp.161.3.473
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发表时间：
2004-03-01
影响因子：
17.7
通讯作者：
McMeniman, M
中科院分区：
文献类型：
--
作者：
Robinson, DG;Woerner, MG;McMeniman, M
目的：随访研究发现，相当数量的精神分裂症患者实现完全康复（即，症状和社会/职业功能的持续改善）。本研究解决恢复在关键的早期病程的illustration.Method：在他们的第一次发作的精神分裂症或情感性精神障碍（N=118）的主题进行了评估，在基线，然后根据药物治疗算法。完全康复需要同时缓解阳性和阴性症状以及充分的社会/职业功能（实现与年龄相适应的角色期望，在没有监督的情况下完成日常生活任务，并参与社会互动）。结果：5年后，47.2%（95% CI = 36.0%-58.4%）的受试者达到症状缓解，25.5%（95% CI = 16.1%-34.7%）的受试者具有足够的社会功能2年或更长时间。仅13.7%（95% CI =6.4%-20.9%）的受试者符合2年或更长时间的完全恢复标准。稳定期认知功能改善与完全恢复、充分的社会/职业功能和症状缓解相关。进入研究前精神病持续时间越短，预示着完全康复和症状缓解。更多的大脑不对称与完全恢复和足够的社会/职业功能;一个emotional情感诊断预测symptomalremission.Conclusions：虽然有些患者首发精神分裂症可以实现持续的症状和功能恢复，在疾病的早期恢复的整体率是低的。
Objective: Follow-up studies have found that a substantial number of patients with schizophrenia achieve full recovery (i.e., sustained improvement in both symptoms and social/vocational functioning) when examined decades after an index admission. This study addressed recovery during the crucial early course of the illness.Method: Subjects in their first episode of schizophrenia or schizoaffective disorder (N=118) were assessed at baseline and then treated according to a medication algorithm. Full recovery required concurrent remission of positive and negative symptoms and adequate social/vocational functioning (fulfillment of age-appropriate role expectations, performance of daily living tasks without supervision, and engagement in social interactions).Results: After 5 years, 47.2% (95% Cl= 36.0%-58.4%) of the subjects achieved symptom remission, and 25.5% (95% Cl= 16.1%-34.7%) had adequate social functioning for 2 years or more. Only 13.7% (95% Cl=6.4%-20.9%) of subjects met full recovery criteria for 2 years or longer. Better cognitive functioning at stabilization was associated with full recovery, adequate social/vocational functioning, and symptom remission. Shorter duration of psychosis before study entry predicted both full recovery and symptom remission. More cerebral asymmetry was associated with full recovery and adequate social/vocational functioning; a schizoaffective diagnosis predicted symptom remission.Conclusions: Although some patients with first-episode schizophrenia can achieve sustained symptomatic and functional recovery, the overall rate of recovery during the early years of the illness is low.