A 20-year multi-follow-up of hallucinations in schizophrenia, other psychotic, and mood disorders
A 20-year multi-follow-up of hallucinations in schizophrenia, other psychotic, and mood disorders
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DOI：
10.1017/s0033291712002206
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发表时间：
2013-06-01
影响因子：
6.9
通讯作者：
Rosen, C.
中科院分区：
文献类型：
--
作者：
Goghari, V. M.;Harrow, M.;Rosen, C.
背景。幻觉是精神病的一个主要方面，也是精神病和情绪障碍的诊断特征。然而，该领域缺乏关于这些疾病中幻觉的长期病程的信息。我们的目的是确定幻觉患者的百分比以及幻觉与康复和工作成就的关系。本研究是对150名年轻患者20年的幻觉轨迹进行前瞻性评估：51名精神分裂症患者，25名分裂情感性患者，25名双相精神病患者，49名单相抑郁症患者。这些患者在住院治疗的指标阶段进行了研究，然后在随后的20年的6次随访中进行了纵向评估。幻觉的纵向病程清晰地区分了精神分裂症与双相情感障碍合并精神病，并提示精神分裂症与分裂情感障碍、双相情感障碍与分裂情感障碍合并抑郁症在诊断上有一定的相似性。在20年的时间里，频繁或持续的幻觉活动是40-45%的精神分裂症患者的特征。早期出现的幻觉预示着所有病人未来都没有康复期。在所有患者中，幻觉活动的增加与工作成就的降低有关。本研究提供了幻觉的前瞻性纵向病程的数据，这是以前在该领域无法获得的，并且是主要精神障碍中精神病的关键特征之一。这些关于主要精神疾病临床病程的信息可以为准确的分类和诊断提供信息。
Background. Hallucinations are a major aspect of psychosis and a diagnostic feature of both psychotic and mood disorders. However, the field lacks information regarding the long-term course of hallucinations in these disorders. Our goals were to determine the percentage of patients with hallucinations and the relationship between hallucinations and recovery, and work attainment.Method. The present study was a prospective evaluation of the 20-year trajectory of hallucinations in 150 young patients : 51 schizophrenia, 25 schizoaffective, 25 bipolar with psychosis, and 49 unipolar depression. The patients were studied at an index phase of hospitalization for hallucinations, and then reassessed longitudinally at six subsequent follow-ups over 20 years.Results. The longitudinal course of hallucinations clearly differentiated between schizophrenia and bipolar disorder with psychosis, and suggested some diagnostic similarities between schizophrenia and schizoaffective disorder, and between bipolar disorder and schizoaffective disorder and depression. Frequent or persistent hallucinatory activity over the 20-year period was a feature of 40-45% of schizophrenia patients. The early presence of hallucinations predicted the lack of future periods of recovery in all patients. Increased hallucinatory activity was associated with reduced work attainment in all patients.Conclusions. This study provides data on the prospective longitudinal course of hallucinations, which were previously unavailable to the field, and are one of the key features of psychosis in major psychiatric disorders. This information on the clinical course of major psychiatric disorders can inform accurate classification and diagnosis.