Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis
Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis
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DOI：
10.1007/s00787-015-0693-5
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发表时间：
2015-12-01
影响因子：
6.4
通讯作者：
Parellada, Mara
中科院分区：
文献类型：
--
作者：
Del Rey-Mejias, Angel;Fraguas, David;Parellada, Mara
本研究的目的是分析早发性精神分裂症谱系障碍（SSD）和情感性精神病（AFP）患者从儿童期到首次精神病发作（FEP）后2年的功能调整变化，以及良好或中等水平的病前调整。我们在招募后对106名青少年（12-17岁）进行了为期2年的FEP随访。采用Cannon-Spoor病前适应量表（c-PAS）儿童期亚量表对98例患者进行儿童期病前适应评估。在FEP后2年使用儿童整体评估量表（c-GAS）或整体功能评估量表（GAF）评估整体功能。功能恶化被定义为从童年到FEP后2年功能调整水平的下降。在病前调整良好或中度的患者中，28.2%的患者出现功能恶化（AFP组26.5%，SSD组29.4%）。用临床总体印象量表（Beta = 1.12; P = 0.02）测量，较长的精神病治疗持续时间（Beta = 0.01; P = 0.01）和较高的FEP症状严重程度（Beta = 1.12; P = 0.02）显著预测了功能恶化的存在，占方差的21.4%。无论诊断（SSD或AFP）如何，几乎三分之一的FEP青少年和良好或中度的病前调整在发病前至FEP后2年内表现出功能恶化。
The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP.