Outcome in early-onset schizophrenia revisited: Findings from the Early Psychosis Prevention and Intervention Centre long-term follow-up study
Outcome in early-onset schizophrenia revisited: Findings from the Early Psychosis Prevention and Intervention Centre long-term follow-up study
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DOI：
10.1016/j.schres.2011.06.009
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发表时间：
2011-09-01
影响因子：
4.5
通讯作者：
McGorry, Patrick D.
中科院分区：
文献类型：
--
作者：
Amminger, G. Paul;Henry, Lisa P.;McGorry, Patrick D.
目的：比较早发性脑梗死患者的长期预后（18岁之前）和成人发作的精神分裂症谱系障碍，他们最初在同一个临床中心被诊断和治疗。723例首发精神病患者的前瞻性随访研究（年龄范围14至30岁）在初次就诊于澳大利亚墨尔本的早期精神病预防和干预中心的早期精神病服务后平均7.4年。结果测量包括简明精神病评定量表、阴性症状评估表、贝克抑郁量表、总体功能评估量表、社会和职业功能评估量表和生活质量量表。对66.9%（484/723）的个体进行了随访，其中75.6%（366/484）在基线时接受了精神分裂症谱系障碍诊断。早发性精神分裂症谱系障碍占11.2%（41/366）。在随访中，早发性个体报告的阳性症状明显较少，其特征是在评估全球功能，社会职业功能和社区功能的措施上明显上级成年发病的个体。早发组也取得了显着更好的职业成果，并有一个更有利的病程，更少的精神病发作在过去两年之前的后续行动。最后，当调查作为一个连续变量，发病年龄较低显着相关，更好的症状和功能outcomes.Conclusions：这些结果质疑的假设，早发性精神分裂症通常有一个不良的结果。对于早发性精神分裂症患者和成人型精神分裂症患者，早期发现和专门治疗首次精神病发作似乎更有效地改善长期功能结局。这种可能性及其原因需要进一步调查。(C)2011 Elsevier B. V.保留所有权利。
Objective: To compare the long-term outcome in individuals with early-onset (before age 18) and adult-onset schizophrenia spectrum disorder who were initially diagnosed and treated in the same clinical center.Method: A prospective follow-up study of 723 consecutive first-episode psychosis patients (age range 14 to 30 years) on average 7.4 years after initial presentation to an early psychosis service, the Early Psychosis Prevention and Intervention Centre in Melbourne, Australia. The outcome measures included the Brief Psychiatric Rating Scale, the Schedule for the Assessment of Negative Symptoms, the Beck Depression Inventory, the Global Assessment of Functioning Scale, the Social and Occupational Functioning Assessment Scale, and the Quality of Life Scale.Results: Follow-up interviews were conducted on 66.9% (484/723) individuals, of whom 75.6% (366/484) received a schizophrenia spectrum disorder diagnosis at baseline. Early-onset schizophrenia spectrum disorder was observed in 11.2% (41/366). At follow-up, individuals with early-onset reported significantly fewer positive symptoms and were characterised by significantly superior functioning on measures assessing global functioning, social-occupational functioning, and community functioning than individuals with adult-onset. The early-onset group also achieved significantly better vocational outcomes and had a more favourable course of illness with fewer psychotic episodes over the last two years prior to follow-up. Finally, when investigated as a continuous variable, younger age at onset significantly correlated with better symptomatic and functional outcomes.Conclusions: These results question the assumption that early-onset schizophrenia typically has a poor outcome. Early detection and specialised treatment for the first psychotic episode appear to be more effective at improving long-term functional outcomes in people with early-onset schizophrenia as in those with adult-onset schizophrenia. This possibility and the reasons for it need further investigation. (C) 2011 Elsevier B.V. All rights reserved.