Recovery in Schizophrenia: Longitudinal Course

精神分裂症的康复：纵向过程

• 批准号: 6824257
• 负责人: MARTIN HARROW
• 金额: $ 24.41万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6824257
• 关键词: anxiety; behavioral /social science research tag; clinical research; family genetics; functional ability; hospital utilization; human subject; interview; locus of control; longitudinal human study; mental health epidemiology; neuropsychological tests; pathologic process; psychological aspect of aging; psychopathology; quality of life; questionnaires; remission /regression; schizophrenia; self concept

DESCRIPTION (provided by applicant): Recently there has been controversy concerning whether as schizophrenia patients get older there are changes in course and outcome. Some or many may recover as they begin to get older, with this involving potential reductions in symptoms and improved global functioning. If these changes occur they could be linked to biological theory about age-related declines in dopamine as people get older. The research involves a 27 year prospectively designed follow-up of a large sample of early onset schizophrenia patients and two control samples. These patients were originally assessed early in their disorder. Since their early acute phase assessment they have been studied systematically 6 times over a 20-year period. Our 20-year longitudinal data indicate the beginning of a decline in psychosis, and an improvement in the percent of schizophrenia patients showing recovery as they begin to get older. This change began at the 15 and 20-year follow-ups, and is statistically significant in some major areas (e.g., global functioning). It is still an open issue as to whether this improvement will reach a plateau, continue or even accelerate at the 27 year follow-up as the originally early onset schizophrenia patients reach 50 years, the second half of life. There has not been a systematic prospective multi-follow-up longitudinal study over a prolonged period despite the different views and the importance to theory about whether poor schizophrenia course and outcome continues or whether there is improvement or "burn out" of psychotic symptoms and complete recovery in some or many as they get older. The current application was designed to help fill this gap in our knowledge about potential changes in schizophrenia symptoms and potential recovery as they get older. This 27-year multi-follow-up will provide data on the cumulative percent of modern-day schizophrenia patients who ever show complete recovery for a period of one of more years. The focus of this proposed 27-year longitudinal study as these patients reach 50 years of age, the second half of life, will be on improvement and on the percent showing recovery as a function of increasing age. Three specific sets of hypotheses will be studied: a) hypotheses about a potential "burn out" of psychotic symptoms as schizophrenia patients begin to age, b) hypotheses about improvement and recovery in schizophrenia as they begin to get older, and c) hypotheses about a specific subtype of schizophrenia which may account for much of the improvement in course and outcome as they get older.

描述（由申请人提供）：最近，关于精神分裂症患者是否随着年龄的增长而改变病程和结局存在争议。一些或许多人可能会恢复，因为他们开始变老，这涉及潜在的减少症状和改善全球功能。如果这些变化发生，它们可能与生物学理论有关，即随着年龄的增长，多巴胺会随着年龄的增长而下降。这项研究涉及一个27年的前瞻性设计的后续大样本的早发性精神分裂症患者和两个对照样本。这些患者最初是在疾病早期进行评估的。自其早期急性期评估以来，在20年的时间内对其进行了6次系统研究。 我们20年的纵向数据表明，精神病开始下降，随着年龄的增长，精神分裂症患者的康复率有所提高。这种变化始于15年和20年随访，在一些主要领域具有统计学意义（例如，全球功能）。随着最初早发性精神分裂症患者达到50岁，即生命的后半期，这种改善是否会在27年随访时达到平台期、持续甚至加速，这仍然是一个悬而未决的问题。目前还没有一个系统的前瞻性多随访纵向研究在一个较长的时间，尽管不同的观点和理论的重要性，无论是贫穷的精神分裂症的过程和结果继续或是否有改善或“烧毁”的精神病症状和完全恢复，在一些或许多人，因为他们变老。目前的应用程序旨在帮助填补我们对精神分裂症症状的潜在变化和随着年龄增长的潜在恢复的知识空白。这项为期27年的多项随访将提供现代精神分裂症患者的累积百分比数据，这些患者曾在一年或更长时间内完全康复。 这项拟议的27年纵向研究的重点是，随着这些患者达到50岁，即生命的后半期，将是改善和显示恢复的百分比作为年龄增加的函数。将研究三组特定的假设：a）随着精神分裂症患者开始衰老，精神病症状可能会“消失”的假设，B）随着精神分裂症患者开始衰老，精神分裂症的改善和恢复的假设，以及c）关于精神分裂症特定亚型的假设，这可能是随着年龄的增长，病程和结局改善的大部分原因。