Obsessive–compulsive symptoms in at‐risk mental states for psychosis: associations with clinical impairment and cognitive function

Obsessive–compulsive symptoms in at‐risk mental states for psychosis: associations with clinical impairment and cognitive function
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精神病高危精神状态下的强迫症状:与临床损伤和认知功能的关联

DOI:
10.1111/acps.12258
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发表时间:
2014
影响因子:
6.7
通讯作者:
Solojenkina
Solojenkina
中科院分区:
医学1区
文献类型:
--
作者:
Schirmbeck;Rausch;Eifler;Solojenkina

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目的强迫症状(OCS)构成精神分裂症的主要合并症。对于精神病高危精神状态 (ARMS) 患者的 OCS 患病率估计差异很大。目前尚不清楚患有或不患有 OCS 共病的 ARMS 患者在一般心理社会功能、精神病性和情感症状以及神经认知能力方面有何不同。方法根据是否存在共病 OCS 对来自干预性试验 PREVENT(精神分裂症二级预防)的高危精神状态患者 (n = 233) 进行分层,并比较几个临床变量。结果符合以下标准的患者强迫症 (OCD) 或出现亚临床 OCS(ARMSposOCS 样本)的患者与未出现 OCS 的患者 (ARMSnegOCS) 在性别、年龄、病前言语智力和教育水平方面没有显着差异。此外,还发现抑郁综合征、基本认知、减弱的精神病和短暂有限的间歇性精神病症状的严重程度相似。然而,ARMSposOCS 患者表现出更多的心理社会功能损伤和更高的一般精神病理学。相比之下,他们在测量工作记忆和即时言语记忆的认知任务中得分较高。结论由于多维评估,结果扩展了之前的结果。随后的纵向研究可能会阐明共病 OCS 如何影响差异化治疗反应,特别是认知行为干预和精神病的转变率。
ObjectiveObsessive–compulsive symptoms (OCS) constitute a major comorbidity in schizophrenia. Prevalence estimations of OCS for patients with at‐risk mental states (ARMS) for psychosis vary largely. It is unclear how ARMS patients with or without comorbid OCS differ regarding general psychosocial functioning, psychotic and affective symptoms and neurocognitive abilities.MethodAt‐risk mental states patients (n= 233) from the interventional trial PREVENT (Secondary Prevention of Schizophrenia) were stratified according to the presence or absence of comorbid OCS and compared on several clinical variables.ResultsPatients, who fulfilled the criteria for obsessive–compulsive disorder (OCD) or presented with subclinical OCS (ARMSposOCS sample), did not significantly differ from patients without OCS (ARMSnegOCS) with regard to gender, age, premorbid verbal intelligence and levels of education. Furthermore, similar severity of depressive syndromes, basic cognitive, attenuated psychotic and brief limited intermittent psychotic symptoms were found. However, ARMSposOCS patients showed more impairment of psychosocial functioning and higher general psychopathology. In contrast, they scored higher in cognitive tasks measuring working memory and immediate verbal memory.ConclusionFindings extend upon previous results due to the multidimensional assessment. Subsequent longitudinal studies might elucidate how comorbid OCS influence differential treatment response, especially to cognitive behavioural interventions and the transition rates to psychosis.
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