Duration of psychosis and outcome in first-episode schizophrenia.
Duration of psychosis and outcome in first-episode schizophrenia.
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DOI：
10.1176/ajp.149.9.1183
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发表时间：
1992-09
期刊：
影响因子：
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通讯作者：
A. Loebel;J. Lieberman;J. Alvir;D. Mayerhoff;S. Geisler;Szymański
中科院分区：
文献类型：
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作者：
A. Loebel;J. Lieberman;J. Alvir;D. Mayerhoff;S. Geisler;Szymański
目的探讨首发精神分裂症患者病程对预后的影响。方法对70例符合研究诊断标准的精神分裂症患者进行为期3年的随访。所有患者在其疾病的急性期和整个随访期间均接受标准化治疗和统一评估。结果以急性精神病症状缓解的时间以及症状缓解的程度来衡量。结果：在初始治疗前，精神病症状的平均持续时间为52周，之前有一个实质性的精神病前期。根据生存分析，发现治疗前的疾病持续时间与缓解时间以及缓解水平显著相关。在回归分析中，控制了与预后相关的诊断和性别变量后，病程对预后的影响仍然显著。疾病持续时间与发病时的年龄、发病方式、病前调整或进入研究时的疾病严重程度无关。结论：治疗前精神病持续时间可能是首发精神分裂症预后的一个重要预测因素。急性精神病症状可能反映了一种活跃的病态过程，如果不通过抗精神病药物治疗得到改善，可能导致持续的发病。这些研究结果的进一步影响进行了讨论。
OBJECTIVE This study was undertaken to assess the potential effect of duration of untreated illness on outcome in a group of first-episode schizophrenic patients. METHOD Seventy patients with schizophrenia diagnosed according to the Research Diagnostic Criteria entered the study and were followed for up to 3 years. All patients received standardized treatment and uniform assessments both during the acute phase of their illness and throughout the follow-up period. Outcome was measured in terms of time to remission of acute psychotic symptoms as well as degree of symptom remission. RESULTS The mean duration of psychotic symptoms before initial treatment was 52 weeks, preceded by a substantial prepsychotic period. According to survival analysis, duration of illness before treatment was found to be significantly associated with time to remission as well as with level of remission. The effect of duration of illness on outcome remained significant when diagnosis and gender variables, themselves associated with outcome, were controlled in a regression analysis. Duration of illness was not correlated with age at onset, mode of onset, premorbid adjustment, or severity of illness at entry into the study. CONCLUSIONS Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia. Acute psychotic symptoms could reflect an active morbid process which, if not ameliorated by neuroleptic drug treatment, may result in lasting morbidity. Further implications of these findings are discussed.