Motor abnormalities in first-episode psychosis patients and long-term psychosocial functioning
Motor abnormalities in first-episode psychosis patients and long-term psychosocial functioning
复制标题
DOI：
10.1016/j.schres.2017.08.050
复制
发表时间：
2018-10-01
影响因子：
4.5
通讯作者：
Peralta, Victor
中科院分区：
文献类型：
--
作者：
Cuesta, Manuel J.;Garcia de Jalon, Elena;Peralta, Victor
运动异常（MAs）在抗精神病药物治疗前和治疗后的首发精神病患者中非常普遍。然而，这些异常在多大程度上对长期社会心理功能具有预测价值尚不清楚。对100例抗精神病首发精神病（PEP）患者进行了广泛的运动评估，包括紧张症、帕金森症、运动障碍、静坐症和神经软症状。患者分别在初始状态和6个月后进行评估。对患者进行自然治疗和环境的随访，并在FEP后6个月、1年、5年和10年通过收集所有可用信息评估他们的社会心理功能。建立了一套线性混合模型，以解释随访期间关于MAs的五个领域（紧张性、帕金森症、无运动障碍、运动障碍和神经软症状）在抗精神病药初始状态和FEP 6个月后的指数发作期间的重复纵向评估。包括基本流行病学变量、精神分裂症诊断和氯丙嗪平均等效剂量抗精神病药物作为协变量。药物初始状态的紧张症状和运动障碍与不良的长期社会心理功能显著相关。此外，PEP 6个月时帕金森病、静坐症、神经软症状和紧张性症状得分较高，但运动障碍得分不高，这与长期社会心理功能不良有显著关联。我们的研究结果增加了经验证据，证明运动异常是精神疾病在抗精神病药物治疗前后的核心表现，对FEP患者长期社会心理功能不良具有很高的预测价值。(C) 2018 Elsevier B.V.版权所有
Motor abnormalities (MAs) are highly prevalent in patients with first-episode psychosis both before any exposure and after treatment with antipsychotic drugs. However, the extent to which these abnormalities have predictive value for long-term psychosocial functioning is unknown.One hundred antipsychotic-naive first-episode psychosis (PEP) patients underwent extensive motor evaluation including catatonic, parkinsonism, dyskinesia, akathisia and neurological soft signs. Patients were assessed at naive state and 6 months later. Patients were followed-up in their naturalistic treatment and settings and their psychosocial functioning was assessed at 6-month, 1 year, 5 year and 10 years from the FEP by collecting all available information.A set of linear mixed models were built to account for the repeated longitudinal assessment of psychosocial functioning during the follow-up regarding to the five domains of MAs (catatonic, parkinsonism, akathisia, dyskinesia and neurologic soft-signs) at index episode at antipsychotic naive state and after 6 months of FEP. Basic epidemiological variables, schizophrenia diagnosis and average of chlorpromazine equivalent doses of antipsychotic drugs were included as covariates.Catatonic signs and dyskinesia at drug-naive state were significantly associated with poor long-term psychosocial functioning. Moreover, higher scores on parkinsonism, akathisia, neurological soft signs and catatonic signs at 6-month of PEP but not dyskinesia showed significant associations with poor long-term psychosocial functioning.Our results added empirical evidence to motor abnormalities as core manifestations of psychotic illness before and after antipsychotic treatment with high predictive value for poor long-term psychosocial functioning in FEP patients. (C) 2018 Elsevier B.V. All rights reserved.