Apathy and Functioning in First-Episode Psychosis
Apathy and Functioning in First-Episode Psychosis
复制标题
DOI：
10.1176/appi.ps.60.11.1495
复制
发表时间：
2009-11-01
影响因子：
3.8
通讯作者：
Melle, Ingrid
中科院分区：
文献类型：
--
作者：
Faerden, Ann;Friis, Svein;Melle, Ingrid
目的：本研究旨在确定哪些患者特征与更高水平的冷漠相关，与健康对照组相比，首发精神病患者的冷漠程度如何，以及冷漠和其他症状（包括阴性子症状）在多大程度上影响首发精神病的功能。研究方法：挪威的主题组织精神病研究包括103名首次发作的精神病患者和62名健康对照组。采用临床医师评定的简化版冷漠评价量表（AES-C-冷漠）对冷漠进行评估。其他临床症状采用阳性和阴性症状量表（PANSS）评定。在随后的分析中使用PANSS五因素模型。使用功能总体评估量表（GAF）的拆分版本评估功能。结果：首发精神病患者临床冷漠率高于健康组（50%以上）。在所有临床变量中，只有病前儿童社会功能、社会功能变化和紊乱症状（PANSS紊乱成分）与AES-C-冷漠有显著相关性，解释了18%的方差。多元回归分析显示，在PANSS的五个组成部分中，只有PANSS阳性对GAF-F评分有显着的独立贡献，AES-C-冷漠评分也是如此，解释了37%的方差。相同的回归模型表明，在PANSS阴性症状，只有平坦的影响作出了独立的功能显着的贡献。结论：冷漠是首发精神病的一种普遍症状，与日常功能有显著的相关性;因此，在治疗开始时应评估冷漠的存在和后果。（精神病学服务60：1495-1503，2009）
Objective: This study aimed to determine which patient characteristics are associated with higher levels of apathy, to what degree first-episode psychosis patients are apathetic compared with a healthy control group, and to what degree apathy and other symptoms (including negative subsymptoms) influence functioning in first-episode psychosis. Methods: The Norwegian Thematically Organized Psychosis research study included 103 first-episode psychosis patients and a healthy control group of 62 persons. Apathy was assessed with the clinician-rated abridged version of the Apathy Evaluation Scale (AES-C-Apathy). Other clinical symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). The PANSS five-factor model was used in the subsequent analyses. Functioning was assessed with the split version of the Global Assessment of Functioning scale (GAF). Results: More than 50% of first-episode psychosis patients were clinically apathetic compared with the healthy group. Of all clinical variables, only premorbid childhood social functioning, change in social functioning, and disorganized symptoms (PANSS disorganized component) had a significant association with AES-C-Apathy, explaining 18% of the variance. Multiple regression analysis revealed that of the five PANSS components, only PANSS positive made a significant independent contribution to the GAF-F score, as did the AES-C-Apathy score, explaining 37% of the variance. The same regression model indicated that among the PANSS negative symptoms, only flat affect made an independent significant contribution to functioning. Conclusions: Apathy is a prevalent symptom in first-episode psychosis and has a significant association with everyday functioning; the presence and consequences of apathy should thus be evaluated at the start of treatment. (Psychiatric Services 60: 1495-1503, 2009)