Valuing prodromal psychosis: What do we get and what is the price?
Valuing prodromal psychosis: What do we get and what is the price?
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DOI：
10.1016/j.schres.2010.03.013
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发表时间：
2010-07-01
影响因子：
4.5
通讯作者：
Lewis, Shon W.
中科院分区：
文献类型：
--
作者：
Drake, Richard J.;Lewis, Shon W.
现在有一个建议，在DSM V中包括“首次精神病的风险综合征”（Woods et al.，2009年）。总结标准：必须存在妄想、幻觉或言语混乱中的至少一种，并充分减弱以保持现实测试，而不会实质性地干扰思维或行为。然而，它们必须是令人痛苦的，并与社会、认知或职业功能的衰退有关。症状必须在过去一个月内平均至少每周出现一次，并在过去一年内恶化或开始。DSM V的其他诊断不能更好地解释它们，精神病必须从未发生过。只有根据被理解为不同的病理过程或不同的预后，或者在确定问题的类别指导治疗或不治疗的决定时，才能区分新的综合征。提出的综合征起源于Yung和McGorry在墨尔本的纵向治疗研究（例如McGorry等人，2002; Yung等人，2004年）。他们的小组定义了三套相互关联的标准，描述了一组可能从预防干预中受益的发展为坦率精神病的“超高风险”的人群。第一组描述了患者的一级亲属患有精神障碍，患有非特异性症状和功能下降。第二组定义为减弱的阳性精神病症状持续
There is now a proposal to include a “risk syndrome for first psychosis” in DSM V (Woods et al., 2009). To summarize the criteria: at least one of delusions, hallucinations or disorganized speech must be present, sufficiently attenuated to preserve reality testing and not to substantially interfere with thinking or behaviour. However, they must be distressing and be associated with decrements in social, cognitive or vocational function. The symptoms must have occurred at least weekly, on average, in the past month and worsened or begun in the past year. Other DSM V diagnoses must not better explain them and psychosis must never have occurred. It is only useful to distinguish a new syndrome on the basis of what is understood as a distinct pathological process; or a distinct prognosis; or at a point where identifying a category of problem guides the decision to treat or not. The syndrome proposed originated with Yung and McGorry's longitudinal treatment studies in Melbourne (eg McGorry et al., 2002; Yung et al., 2004). Their group defined three linked sets of criteria describing a group at “Ultra-High Risk” of developing frank psychosis who might benefit from preventative interventions. The first set described patients with a first-degree relative with psychotic disorder, suffering nonspecific symptoms and a specified decline in functioning. The second set defined attenuated positive psychotic symptoms sustained