Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?
Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?
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DOI：
10.1016/j.psychres.2015.05.018
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发表时间：
2015-08-30
影响因子：
11.3
通讯作者：
Fusar-Poli, Paolo
中科院分区：
文献类型：
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作者：
Falkenberg, Irina;Valmaggia, Lucia;Fusar-Poli, Paolo
除了减轻的精神病症状外，具有发生精神病的临床高风险的个体还表现出广泛的精神病理学特征。其中一些可能被主观地认为比其他更令人不安，因此可能更有可能引发寻求帮助的行为。我们的目的是调查高危个体在接受早期识别服务时主观认为最令人痛苦的症状的性质和患病率，并确定它们对基线和纵向功能和临床结果的影响。审查了 2001 年至 2011 年间 221 名符合超高风险 (UHR) 标准并在专门的早期干预服务（“伦敦南部的外展和支持”）接受护理的客户的临床记录。主要结果指标是客户主观报告的寻求帮助的原因、共病 DSM-IV SCID 诊断、向精神病的转变、基线时和中位随访期 4.5 年后的心理社会功能。情感症状，即抑郁和/或焦虑，是最常报告的寻求帮助的主观原因（47.1%）。 39.8% 的人报告有亚阈值精神病症状。就诊时的主观主诉与转变为精神病之间没有显着关联。然而，与报告阈下精神病症状的组相比，报告情感症状作为其在基线寻求帮助的主要主观原因的组在心理社会功能方面的纵向结果显着较差。在初次就诊时对 UHR 个体的主观主诉进行评估可能有助于确定未来功能结果的预测因素并相应地调整治疗方案。 (C) 2015 Elsevier Ireland Ltd. 保留所有权利。
In addition to attenuated psychotic symptoms, individuals at high clinical risk of developing psychosis display a wide range of psychopathological features. Some of these may be subjectively perceived as more troubling than others and may therefore be more likely to trigger help-seeking behavior. We aimed at investigating the nature and prevalence of symptoms subjectively considered most distressing by high-risk individuals at the time of their presentation to early recognition services and to determine their impact on baseline and longitudinal functional and clinical outcomes. The clinical records of 221 clients meeting ultra-high risk (UHR) criteria and receiving care at a specialized early intervention service ("Outreach and Support in South London") between 2001 and 2011 were reviewed. Main outcome measures were reason to seek help as subjectively reported by the clients, comorbid DSM-IV SCID diagnoses, transition to psychosis, psychosocial functioning at baseline and after a median follow-up period of 4.5 years. Affective symptoms, i.e., depression and/or anxiety, were the most commonly reported subjective reasons to seek help (47.1%). Sub-threshold psychotic symptoms were reported by 39.8%. There was no significant association between subjective complaints at presentation and transition to psychosis. However, the group reporting affective symptoms as their main subjective reason to seek help at baseline had a significantly poorer longitudinal outcome in psychosocial functioning relative to the group reporting sub-threshold psychotic symptoms. Assessment of subjective complaints in UHR individuals at initial presentation may help to identify predictors of future functional outcome and tailor treatments accordingly. (C) 2015 Elsevier Ireland Ltd. All rights reserved.