Identifying persistent negative symptoms in first episode psychosis.
Identifying persistent negative symptoms in first episode psychosis.
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DOI：
10.1186/1471-244x-12-224
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发表时间：
2012-12-06
期刊：
影响因子：
4.4
通讯作者：
Lepage M
中科院分区：
文献类型：
--
作者：
Hovington CL;Bodnar M;Joober R;Malla AK;Lepage M
虽然持续性阴性症状（PNS）是已知的，有助于显着不良的功能结果，他们仍然知之甚少。我们研究了各种PNS定义的启发式价值及其各自在首发精神病（FEP）患者中的患病率。我们还将这些定义与缺陷综合征（PDS）的替代定义进行了对比，以确定同一FEP队列中的缺陷综合征（DS）。根据阴性症状评估量表（SANS）的评分，将158例FEP患者分为PNS组和非PNS组。PNS的定义如下：1）SANS的至少1个总体分量表评分≥ 3（PNS_1）; 2）SANS的至少2个总体分量表评分≥ 3（PNS_2）; 3）特定SANS分量表和项目组合评分≥ 3（PNS_H）。对于所有三种定义，症状必须至少连续存在六个月。在进入该项目时以及随后的1、2、3、6、9和12个月时测量阴性症状。在第一次评估和第12个月时量化功能结局。PNS患病率：PNS_1（27%）、PNS_2（13.2%）、PNS_H（13.2%）。当应用PDS时，发现DS的患病率为3%。无论采用何种定义，与非PNS组相比，PNS组患者在第12个月时的功能明显较差。所有三种PNS定义均显示与12个月时的功能结局相似。持续的阴性症状存在于约27%的患有情感性和非情感性精神病的FEP患者中。尽管之前对PNS是否代表阴性症状的一个单独子域存在疑问，但目前的研究表明，与DS相比，PNS可能更适用于FEP。虽然这三种PNS定义在预测功能结局方面具有可比性，但我们认为所采用的PNS定义取决于手头的临床或研究目标。
Although persistent negative symptoms (PNS) are known to contribute significantly to poor functional outcome, they remain poorly understood. We examined the heuristic value of various PNS definitions and their respective prevalence in patients with first episode psychosis (FEP). We also contrasted those definitions to the Proxy for the Deficit Syndrome (PDS) to identify deficit syndrome (DS) in the same FEP cohort. One hundred and fifty-eight FEP patients were separated into PNS and non-PNS groups based on ratings from the Scale for Assessment of Negative Symptoms (SANS). PNS was defined in the following ways: 1) having a score of 3 or greater on at least 1 global subscale of the SANS (PNS_1); 2) having a score of 3 or more on at least 2 global subscales of the SANS (PNS_2); and 3) having a score of 3 or more on a combination of specific SANS subscales and items (PNS_H). For all three definitions, symptoms had to be present for a minimum of six consecutive months. Negative symptoms were measured upon entry to the program and subsequently at 1,2,3,6,9 and 12 months. Functional outcome was quantified at first assessment and month 12. PNS prevalence: PNS_1 (27%); PNS_2 (13.2%); PNS_H (13.2%). The prevalence of DS was found to be 3% when applying the PDS. Regardless of the definition being applied, when compared to non-PNS, patients in the PNS group were shown to have significantly worse functioning at month 12. All three PNS definitions showed similar associations with functional outcome at month 12. Persistent negative symptoms are present in about 27% of FEP patients with both affective and non-affective psychosis. Although there has previously been doubt as to whether PNS represents a separate subdomain of negative symptoms, the current study suggests that PNS may be more applicable to FEP when compared to DS. Although all three PNS definitions were comparable in predicting functional outcome, we suggest that the PNS definition employed is dependent on the clinical or research objective at hand.