EPIDEMIOLOGY OF NEWLY DIAGNOSED PSYCHOTIC DISORDERS

拟议的流行病学调查的总体目标是 进行全面的诊断、现象学、家族性和 一例新诊断精神病患者的心理社会评价 并评估心理社会和临床状况的变化 在两年内。除了评估古典音乐 预后因素，如病前调整、特征 发病情况、突发事件、质量和严重程度 在索引发作时的精神病症状，以及 精神障碍，拟议的研究将调查 自杀意念的发生、稳定性和后果， 自杀未遂和药物滥用。超过一年 两年期间，所有第一次接触精神健康的人 将对纽约州萨福克县的设施进行筛查 可能包含在该项目中。患者满足最初的要求 筛查将进行全面的诊断评估， 这将在六个月后重复。当时，病人 确诊的新诊断精神病患者将被归类为 患有精神分裂症或非精神分裂症。他们会 然后接受心理社会面谈和他们的家庭成员 将进行诊断性评估。初次接触后两年 (从心理社会访谈开始18个月)，诊断和 将重复对患者进行心理社会评估。 建议进行大型、有代表性的研究的意义 样本取决于其关注的对象：新诊断的患者 不是首次和再次入院病例的混合样本；纵向的 确定的诊断，而不是横断面分类； 包括同时存在药物滥用和其他疾病的患者 精神障碍通常被排除在之前 研究；精神药物模式的相对影响 精神分裂症与非精神分裂症的用药比较 精神病患者将提供严格的测试 关于预后指标的发现的特异性；直接获得 关于一级亲属的诊断信息；以及详细的 关于自杀行为的信息。我们成功地进行了 拟议的研究将确定进一步跟进的可取性 这群人和他们的一级亲属。

The overall goal of the proposed epidemiologic investigation is to conduct a comprehensive diagnostic, phenomenological, familial, and psychosocial evaluation of a sample of newly diagnosed psychotic patients and to assess changes in psychosocial and clinical status over a two-year period. In addition to assessing classical prognostic factors, such as premorbid adjustment, characteristics of illness onset, precipitating events, quality and severity of psychotic symptoms at the index episode, and family history of mental disorder, the proposed study will investigate the occurrence, stability, and consequences of suicidal ideation, suicide attempts and substance abuse in this population. Over a two year period, all first lifetime contacts to mental health facilities in Suffolk County, New York, will be screened for potential inclusion in the project. Patients satisfying an initial screen will be administered a comprehensive diagnostic evaluation, which will be repeated six months later. At that time, patients with a confirmed newly diagnosed psychosis will be classified as having schizophrenia or a non-schizophrenic disorder. They will then be given a psychosocial interview and their family members will be assessed diagnostically. Two years from initial contact (18 months from the psychosocial interview), the diagnostic and psychosocial assessments of the patients will be repeated. The significance of the proposed study of a large, representative sample rests on its attention to: newly diagnosed patients rather than a mixed sample of first and readmission cases; longitudinally determined diagnoses rather than cross-sectional categorization; the inclusion of patients with coexisting substance abuse and other psychiatric disorders who typically were excluded from prior studies; the relative effects of patterns of psychotropic medication; the comparison of schizophrenic and non-schizophrenic psychotic patients which will provide rigorous tests of the specificity of findings on prognostic indicators; obtaining direct diagnostic information on first-degree relatives; and detailed information on suicidal behaviors. Our success in conducting the proposed study will determine the advisability of further following this cohort and their first-degree relatives.