Validity of the Prodromal Risk Syndrome for First Psychosis: Findings From the North American Prodrome Longitudinal Study
Validity of the Prodromal Risk Syndrome for First Psychosis: Findings From the North American Prodrome Longitudinal Study
复制标题
DOI：
10.1093/schbul/sbp027
复制
发表时间：
2009-09-01
影响因子：
6.6
通讯作者：
McGlashan, Thomas H.
中科院分区：
文献类型：
--
作者：
Woods, Scott W.;Addington, Jean;McGlashan, Thomas H.
在过去的十年中，治疗和预防研究招募了被认为有未来精神病风险的患者。这些患者被认为有精神病的风险，因为符合从精神病前驱症状的回顾性报告中得出的研究标准。本研究评估了前瞻性“前驱风险综合征”结构的诊断有效性。通过前驱综合征结构化访谈评估符合北美前驱综合征纵向研究中前驱综合征标准的患者（n = 377）与正常对照组（NC, n = 196）、寻求帮助组（HSC, n = 198）、家族性高危组（FHR, n = 40）和分裂型人格障碍组（SPD, n = 49）进行比较。比较了横断面人口学、症状、功能、合并症诊断和家族史评估领域的变量以及随访结果。前驱风险综合征患者作为一个群体，在所有领域都与NC受试者显著区分开，在许多这些领域的大多数措施上与HSC受试者和FHR受试者区分开来。青少年和青壮年SPD患者虽然在定义上不同于前驱症状患者，但在多项指标上与前驱症状相似，这与年轻患者SPD可能是精神病的独立危险综合征相一致。对首次精神病的前驱风险综合征诊断有效性的有力证据提出了将其纳入精神疾病诊断和统计手册（第五版）的评估问题。
Treatment and prevention studies over the past decade have enrolled patients believed to be at risk for future psychosis. These patients were considered at risk for psychosis by virtue of meeting research criteria derived from retrospective accounts of the psychosis prodrome. This study evaluated the diagnostic validity of the prospective "prodromal risk syndrome" construct. Patients assessed by the Structured Interview for Prodromal Syndromes as meeting criteria of prodromal syndromes (n = 377) from the North American Prodrome Longitudinal Study were compared with normal comparison (NC, n = 196), help-seeking comparison (HSC, n = 198), familial high-risk (FHR, n = 40), and schizotypal personality disorder (SPD, n = 49) groups. Comparisons were made on variables from cross-sectional demographic, symptom, functional, comorbid diagnostic, and family history domains of assessment as well as on follow-up outcome. Prodromal risk syndrome patients as a group were robustly distinguished from NC subjects across all domains and distinguished from HSC subjects and from FHR subjects on most measures in many of these domains. Adolescent and young adult SPD patients, while distinct from prodromal patients on definitional grounds, were similar to prodromals on multiple measures, consistent with SPD in young patients possibly being an independent risk syndrome for psychosis. The strong evidence of diagnostic validity for the prodromal risk syndrome for first psychosis raises the question of its evaluation for inclusion in Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).