Subtyping first-episode non-affective psychosis using four early-course features: potentially useful prognostic information at initial presentation.
Subtyping first-episode non-affective psychosis using four early-course features: potentially useful prognostic information at initial presentation.
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DOI：
10.1111/eip.12026
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发表时间：
2014-02
影响因子：
2
通讯作者：
Ionescu DF
中科院分区：
文献类型：
--
作者：
Compton MT;Kelley ME;Ionescu DF
原发性精神障碍的症状、病程和结局的异质性使预后、治疗和研究的各个方面复杂化。本研究旨在根据4个早期特征（病前学业功能、病前社会功能、前驱症状持续时间和精神病发作时的年龄）确定可解释的首发非情感性精神病亚型。数据来自200名在公共部门住院单位住院的首发非情感性精神病患者，用于潜在的个人资料分析。然后使用方差分析沿沿着多个临床维度比较衍生的亚型。使用四个早期课程的功能，三个类派生。良好的病前/短前驱症状亚型的特征是阳性症状的严重程度较低，更好的社会/职业/全球功能，以及未经治疗的精神病的持续时间较短;差的病前/早发亚型表现出更大的阴性和专注症状，以及更大的心理社会问题;长前驱症状/晚发亚型的特征是更大的烦躁症状。研究结果表明，需要进一步研究与第一次发病样本的效用的基础上早期课程（发病前，前驱期，发病相关）的特点分型。这些努力可以加强异质性的解析，从而推进临床实践和研究。
Heterogeneity of symptoms, course, and outcomes in primary psychotic disorders complicates prognosis, treatment, and diverse aspects of research. This study aimed to identify interpretable subtypes of first-episode nonaffective psychosis based on four early-course features (premorbid academic functioning, premorbid social functioning, duration of the prodrome, and age at onset of psychosis). Data from 200 well-characterized patients hospitalized in public-sector inpatient units for first-episode nonaffective psychosis were used in latent profile analyses. Derived subtypes were then compared along a number of clinical dimensions using analyses of variance. Using four early-course features, three classes were derived. A good premorbid/short prodrome subtype was characterized by a lower severity of positive symptoms, better social/occupational/global functioning, and a shorter duration of untreated psychosis; a poor premorbid/early onset subtype demonstrated greater negative and preoccupation symptoms, as well as greater psychosocial problems; and a long prodrome/late onset subtype was characterized by greater dysphoric symptoms. Findings indicate a need for further research with first-episode samples on the utility of subtyping based on early-course (premorbid, prodromal, and onset-related) characteristics. Such efforts could enhance the parsing of heterogeneity, thereby advancing clinical practice and research.
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