functioning

功能
  • 文章类型: Journal Article
    目前对听力损失(HL)的临床评估通常仅限于可以评估狭窄范围的听力障碍的受控实验室环境。由HL引起的大多数日常生活挑战无法在临床方法中测量。要筛选个人的需求和限制,通过国际合作,开发了一份名为hear-command工具的问卷,并对其进行了定性验证,符合世界卫生组织的国际功能分类,残疾,和听力损失的健康框架(ICF)核心集。该工具使医疗保健专业人员(HCP)能够将ICF框架集成到临床和非临床环境中的患者评估和患者报告结果(PRO)中。目的是为包括ENT和听觉声学在内的各个领域的未来应用提供一般基础和起点。结果可以用于以基于证据的方式定义和支持康复。本文介绍了与听力正常个体相比,使用该工具对轻度至中度重度HL个体的验证和研究结果。
    使用横断面多中心研究,该工具在德国的215名参与者中分发,美国,埃及,充满德语,英语,或阿拉伯语。定义了三个结局评分和相应的残疾程度:听力相关,与听力无关,和言语感知得分。进行了内容和构造验证,并评估了该工具的内部一致性。
    提取的结构包括“听觉处理功能”,\"音质兼容性\",“倾听和沟通功能”,“人际互动功能和基础架构可访问性”,“社会决定因素和基础设施兼容性”,“其他感觉统合功能”,和“认知功能”。关于内容的有效性,研究表明,正常听力参与者与HL患者在听力相关和言语感知评分方面存在显著差异.可靠性评估显示出高度的内部一致性(Cronbach'sα=0.9)。
    结果证明了hear-command工具的高含量和结构有效性。该工具可以有效代表患者对HL和听力相关功能的看法,并提高治疗计划和康复的有效性。广泛的有针对性的概念提供了日常生活听力障碍及其对患者功能和生活质量影响的独特概述。
    UNASSIGNED: Current clinical assessments for Hearing Loss (HL) are often limited to controlled laboratory settings in which a narrow spectrum of hearing difficulties can be assessed. A majority of the daily life challenges caused by HL cannot be measured in clinical methodologies. To screen the individuals\' needs and limitations, a questionnaire named the HEAR-COMMAND tool was developed and qualitatively validated through an international collaboration, aligning with the World Health Organization\'s International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss. The tool empowers healthcare professionals (HCPs) to integrate the ICF framework into patient assessments and patient-reported outcomes (PRO) in clinical and non-clinical settings. The aim is to provide a general foundation and starting point for future applications in various areas including ENT and hearing acoustics. The outcome can be employed to define and support rehabilitation in an evidence-based manner. This article presents the validation and research outcomes of using the tool for individuals with mild to moderately severe HL in contrast to normal-hearing individuals.
    UNASSIGNED: Using a cross-sectional multicenter study, the tool was distributed among 215 participants in Germany, the USA, and Egypt, filled in German, English, or Arabic. Three outcome scores and the corresponding disability degree were defined: hearing-related, non-hearing-related, and speech-perception scores. The content and construct validation were conducted, and the tool\'s internal consistency was assessed.
    UNASSIGNED: The extracted constructs included \"Auditory processing functionality\", \"Sound quality compatibility\", \"Listening and communication functionality\", \"Interpersonal interaction functionality and infrastructure accessibility\", \"Social determinants and infrastructure compatibility\", \"Other sensory integration functionality\", and \"Cognitive functionality\". Regarding content validity, it was demonstrated that normal-hearing participants differed significantly from individuals with HL in the hearing-related and speech-perception scores. The reliability assessment showed a high internal consistency (Cronbach\'s alpha = 0.9).
    UNASSIGNED: The outcome demonstrated the HEAR-COMMAND tool\'s high content and construct validity. The tool can effectively represent the patient\'s perspective of HL and hearing-related functioning and enhance the effectiveness of the treatment plans and rehabilitation. The broad range of targeted concepts provides a unique overview of daily life hearing difficulties and their impact on the patient\'s functioning and quality of life.
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  • 文章类型: Journal Article
    目标:职能管理和康复是一种标准化的心理教育干预措施,派生自“积分”,对康复过程中的人们进行有效的salutogenic心理教育干预,旨在改善精神病住宅设施(PRF)中精神病患者的康复和功能。这项研究的目的是评估该干预措施的主要和次要结果,该干预措施专门针对基于证据的结构化干预措施似乎很少且可取的PRF。
    方法:在北部9个PRF中招募了66名精神病患者,Center和南意大利和63进行了多中心随访研究,并进行了两个时间点评估(t0,治疗前和t1,6个月;)。在每个时间点,通过个人和社会绩效量表(PSP)将社会功能评估为主要结果;此外,精神病理学状况通过简明精神病学评定量表(BPRS)进行评估,恢复评估量表(RAS)通过可重复电池评估神经心理学状态(RBANS)的认知功能,通过压力量表进行压力管理,通过改良五点测验(M-FPT)的认知灵活性,情绪智力指数(EI-I),PRF气氛和用户对PFR的意见,通过特设问卷。能力知识,会话的效用和愉快性是通过临时项目列表来衡量的。
    结果:根据DSM-5-TR,66例52例(82,5%)受精神分裂症影响,11例(17,5%)由躁郁症I型障碍伴精神病症状。在研究结束时,43(68,3%)为男性,57人(90.5%)为单身,5人(7.9%)参与,1人(1.6%)已婚;45人(71.4%)失业。PSP的总分,RAS,BPRS,班斯,压力管理,能力知识,会话的实用性和愉悦性在t1与t1时显示出统计学上的显着改善。t0.5个M-FPT中的两个子量表显示出统计学上的显着改善。情商,单位气氛和用户对PFR的意见没有统计学意义。随访研究结束六个月后,样本中的22个人被解雇,营业额很高。
    结论:经过六个月的随访(短时间),这些结果表明功能有所改善,主要结果,以及以下次要结果变量:RAS,BPRS,班斯,压力管理,能力知识,M-FPT的5分中有两个分尺,会话的实用性和愉快性。总的来说,观察到心理教育结构化干预对关键恢复变量的显着影响。需要进一步的研究来解决这些改进的程度和持续时间。
    OBJECTIVE: Functional Management and Recovery is a standardized Psychoeducational Intervention, derived from \"Integro\", an effective salutogenic-psychoeducational intervention for people in recovery journey, designed to improve recovery and functioning of individuals with psychotic disorders in Psychiatric Residential Facilities (PRFs). The aim of this study is to evaluate the primary and secondary outcomes of this intervention elaborated specifically for PRFs where evidence based structured interventions seem rare and desirable.
    METHODS: 66 individuals with psychotic disorders were recruited in 9 PRFs dislocated in the North, Center and South Italy and 63 underwent a multicenter follow-up study with a two time-point evaluation (t0, pre-treatment and t1, 6 months; ). At each time point, social functioning was assessed as primary outcome by the Personal and Social Performance scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), Recovery by Recovery Assessment Scale (RAS), Cognitive Functioning by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Stress management by Stress-Scale, Cognitive Flexibility by Modified Five-Point Test (M-FPT), Emotional Intelligence by Emotional Intelligence Index (EI-I), the PRF Atmosphere and the Opinion of users about the PFR by an ad hoc questionnaire. The Abilities Knowledge, the Utility and Pleasantness of sessions were measured by an ad hoc list of items.
    RESULTS: 63 individuals out of 66, 52 (82,5%) affected by schizophrenia and 11 (17,5%) by bipolar I disorder with psychotic symptoms according to DSM-5-TR completed the study. At the end of the study, 43 (68,3%) were male, 57 (90.5%) were single, 5 (7.9%) engaged, 1 (1.6%) married; 45 (71.4%) unemployed. The total scores of PSP, RAS, BPRS, BANS, Stress management, Abilities Knowledge, Utility and Pleasantness of sessions showed a statistically significant improvement at t1 vs. t0. Two sub-scales out of 5 of M-FPT showed a statistically significant improvement. The Emotional Intelligence, the Unit Atmosphere and the Opinion of Users about PFR improved without statistical significance. Six months after the end of the follow-up study 22 individuals of the sample were dismissed with a very high turnover.
    CONCLUSIONS: After a six-month follow-up (a short period of time), these results showed improvement in functioning, the primary outcome, as well as in the following secondary outcome variables: RAS, BPRS, BANS, Stress management, Abilities Knowledge, two sub-scales out of 5 of M-FPT, Utility and Pleasantness of sessions. Overall, a remarkable impact of psychoeducational structured intervention on the key Recovery variables is observed. Further studies are needed to address extent and duration of these improvements.
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  • 文章类型: Journal Article
    虽然老年人的流动性对健康和福祉至关重要,值得注意的是,目前,没有德语框架来衡量老年人的步行能力,也考虑到一个人的功能状态。因此,我们结合了专家研讨会的结果,文献综述,和德尔福共识调查。通过这个,我们确定并评估了与老年人步行能力相关的指标,另外关注他们的功能状态。专家讲习班和审查导致了一份广泛的潜在指标清单,我们希望对未来的研究有所帮助。然后在三级德尔福专家调查中对这些指标进行了调整和评级。进行了第四轮额外的德尔菲轮,以评估每个指标对不同的脆弱水平的相关性,即“健壮,\"\"前脆弱,“和”脆弱。“20至28名专家参加了德尔福调查的每一轮。Delphi过程得出了72个指标的列表,这些指标被认为与老年人群的步行能力有关,分为三个主要类别:“建筑环境和运输基础设施,\"\"可访问性和会议场所,\"和\"吸引力和安全感。“对于其中35个指标,有人建议应额外考虑功能状态。该框架代表了在全面涵盖老年人主观和客观步行能力指标方面迈出的重要一步,同时还纳入了与老年人相关的功能方面。在社区设置中测试和应用指标集将是有益的。
    While mobility in older age is of crucial importance for health and well-being, it is worth noting that currently, there is no German language framework for measuring walkability for older adults that also considers the functional status of a person. Therefore, we combined the results of an expert workshop, a literature review, and a Delphi consensus survey. Through this, we identified and rated indicators relevant for walkability for older adults, additionally focusing on their functional status. The expert workshop and the review led to an extensive list of potential indicators, which we hope will be useful in future research. Those indicators were then adapted and rated in a three-stage Delphi expert survey. A fourth additional Delphi round was conducted to assess the relevance of each indicator for the different frailty levels, namely \"robust,\" \"pre-frail,\" and \"frail.\" Between 20 and 28 experts participated in each round of the Delphi survey. The Delphi process resulted in a list of 72 indicators deemed relevant for walkability in older age groups, grouped into three main categories: \"Built environment and transport infrastructure,\" \"Accessibility and meeting places,\" and \"Attractiveness and sense of security.\" For 35 of those indicators, it was suggested that functional status should be additionally considered. This framework represents a significant step forward in comprehensively covering indicators for subjective and objective walkability in older age, while also incorporating aspects of functioning relevant to older adults. It would be beneficial to test and apply the indicator set in a community setting.
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  • 文章类型: Journal Article
    创伤后应激障碍(PTSD)的心理治疗假设PTSD症状的改善将导致功能的改善。然而,很少有研究研究这些结构之间的动态相互作用。使用随机拦截交叉滞后面板模型,我们检查了功能和创伤后应激障碍之间的关系,既建模为总分,又建模为DSM-5子集群,在主要针对功能的十二个疗程中。参与者是161名患有PTSD的退伍军人,他们参加了一项随机对照试验,比较了目前的中心疗法和增强版本的适应性披露。总的来说,PTSD症状,以PTSD总分衡量,导致功能变化比预测PTSD症状的功能变化更频繁,尽管这些影响直到第7次会议才出现。在子集群方面,PTSD子集群B(入侵)的功能预测变化,C(回避),与这些亚簇预测功能的时间点相比,在更多的时间点和E(唤醒和反应性的改变)。在以功能为中心的治疗中,PTSD与功能之间的动态关系很复杂,功能在减轻PTSD的一些核心症状中起着重要作用。
    Psychotherapies for posttraumatic stress disorder (PTSD) assume that PTSD symptom improvement will lead to improvements in functioning. Yet, few studies have examined the dynamic interplay between these constructs. Using a random intercepts cross-lagged panel model, we examined the association between functioning and PTSD, both modeled as a total score and as the DSM-5 subclusters, across twelve sessions of treatments that chiefly target functioning. Participants were 161 Veterans with PTSD enrolled in a randomized controlled trial comparing present centered therapy and an enhanced version of adaptive disclosure. Overall, PTSD symptoms, measured as the total PTSD score, led to changes in functioning more frequently than functioning predicting PTSD symptoms, although these effects did not appear until session 7. In terms of subclusters, functioning predicted changes in the PTSD subclusters B (intrusions), C (avoidance), and E (alterations in arousal and reactivity) at more timepoints compared to timepoints at which these subclusters predicted functioning. The dynamic relationships between PTSD and functioning in the context of functioning-focused treatments are complex, with functioning playing an important role in reduction of some of the core symptoms of PTSD.
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  • 文章类型: Journal Article
    为了确定定期收集瑞士运作数据的官方来源,为了概述现有数据及其可比性,并评估数据在多大程度上适合于制定起作用的度量和指标。
    通过迭代搜索确定数据源。采用了标准化规则,使用当前的世卫组织功能和残疾调查作为内容比较的参考框架,绘制来源评估的功能信息。
    确定了四个来源:瑞士健康调查,欧洲的老龄化和退休(SHARE),瑞士健康调查(SHS)洛桑队列65+(Lc65+),瑞士家庭事务委员会(SHP)。所有工具都解决了睡眠功能,能级,情感功能,和疼痛的感觉。此外,九个功能类别在三个来源中是常见的。
    瑞士的人口数据来源通常收集可比功能数据,可以作为创建功能指标的基础。其中,该指标与补充死亡率和发病率数据相关,并支持对康复和长期护理需求的估计.
    UNASSIGNED: To identify official sources that routinely collect data on functioning in Switzerland, to provide an overview of the existing data and its comparability, and to assess the extent to which the data is suitable for developing a functioning metric and indicator.
    UNASSIGNED: Data sources were identified through an iterative search. Standardized rules were applied to map the functioning information assessed by the sources using a current WHO functioning and disability survey as a reference framework for the content comparison.
    UNASSIGNED: Four sources were identified: the Swiss Survey of Health, Ageing and Retirement in Europe (SHARE), the Swiss Health Survey (SHS), the Lausanne cohort 65+ (Lc65+), and the Swiss Household Panel (SHP). All tools addressed sleep functions, energy level, emotional functions, and sensation of pain. Additionally, nine functioning categories were common across three sources.
    UNASSIGNED: Population data sources in Switzerland routinely collect comparable functioning data, which can serve as the basis for creating a functioning indicator. Among others, this indicator is relevant to complement mortality and morbidity data and to support both the estimation of rehabilitation and long-term care needs.
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  • 文章类型: Journal Article
    双相情感障碍(BD)1意味着在正常状态下执行功能受损,从而干扰社会心理功能。虚拟现实评估在效率和生态有效性方面可能会比传统评估更具优势。这项研究的目的是验证一种新颖的虚拟烹饪任务(VCT),用于评估BD患者的执行功能。这是一项横断面研究,其中使用VCT和一系列计算机化标准任务(CST)评估了一组BD患者(n=42)和健康对照(n=42)。此外,两种评估形式对心理社会功能的影响,用快速测量,进行了调查,以检查生态有效性。在BD组中,干扰显著受损,在CST和VCT中发现了工作记忆和持续注意力。然而,VCT也揭示了计划和解决问题的缺陷。关于心理社会功能,在评估时,只有VCT变量能够预测FAST评分.VCT在评估BD的执行功能和现实生活功能方面比CST具有更高的敏感性。这为在BD中设计用于诊断和治疗目的的新型认知评估提供了证据。
    Bipolar disorder (BD)1 implies impairments in executive functions during euthymia that interfere in psychosocial functioning. Virtual reality assessments may confer advantages respect to traditional assessments in terms of efficiency and ecological validity. The aim of this study was to validate a novel Virtual Cooking Task (VCT) for executive functions assessment in euthymic patients with BD. This is a cross-sectional study in which a group of BD patients (n = 42) and healthy controls (n = 42) were assessed with the VCT and a battery of computerized standard tasks (CST). Additionally, the influence on psychosocial functioning of both forms of assessment, measured with the FAST, was investigated to check ecological validity. In BD group significant impairments in interference, working memory and sustained attention were found in CST and VCT respect to controls. However, deficits in planning and problem-solving were also revealed with the VCT. With respect to psychosocial functioning, only VCT variables were able to predict FAST scores at the assessment time. The VCT showed a greater sensitivity than CST to assess executive functions and real-life functioning in BD. This provides evidence about the opportunity to design novel cognitive assessments for diagnostic and therapeutic purposes in BD.
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  • 文章类型: Journal Article
    繁荣是指一种广义的幸福。当代蓬勃发展的研究往往优先于积极情绪的理论和测量结构,因此,繁荣经常被概念化为涉及积极情绪而不是消极情绪。因此,积极的情绪,关于繁荣的一些观点,被视为“美好生活”的重要组成部分。“本文探讨了美好生活概念的细微差别,专注于积极情绪和繁荣之间的相互作用。通过对当代繁荣观点的分析,我们强调了繁荣概念化的多样性,以及这种多样性对繁荣理论家的影响。我们的评论揭示了关于积极情绪在追求美好生活中的重要性的观点存在重大差异。此外,我们描述了繁荣的目标清单方法和功能方法之间的理论区别,突出各自的优点和局限性。关于积极情绪是否是美好生活的必要组成部分的理论分歧仍然存在,因此,促使人们对将其纳入繁荣模式的理由进行严格审查。最后,我们强调在定义福祉时需要更多的理论清晰度,以告知研究努力和社会话语。我们建议,对繁荣发展和维持变化的充分理解需要承认结构与积极和消极情绪之间的更复杂关系,同时拥抱准确的人类生活模式中不可避免的文化和个人多样性。
    Flourishing refers to one kind of generalized wellbeing. Contemporary flourishing research often privileges positive emotion in the theorization and measurement of the construct, such that flourishing is frequently conceptualized as involving a predominance of positive over negative emotions. Positive emotions are thus, on some views of flourishing, seen as an essential component of \"the good life.\" This paper explores the nuanced variations in conceptions of the good life, focusing on the interplay between positive emotion and flourishing. Through an analysis of contemporary perspectives on flourishing, we underscore the diversity in conceptualizations of flourishing and the implications of this diversity for flourishing theorists. Our review reveals significant disparities in perspectives regarding the significance of positive emotion in the pursuit of a good life. Furthermore, we delineate the theoretical distinctions between objective-list approaches and functional approaches to flourishing, highlighting their respective advantages and limitations. Theoretical dissensus persists regarding whether positive emotion is a necessary constituent of the good life, thus prompting a critical examination of the justification for its inclusion in flourishing models. Finally, we emphasize the need for greater theoretical clarity in defining wellbeing to inform both research endeavors and societal discourse. We suggest that an adequate appreciation of variation in the development and maintenance of flourishing requires admitting for more complex relationships between the construct and both positive and negative emotionality, while embracing the cultural and individual variety that are unavoidable in accurate models of human life.
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  • 文章类型: Journal Article
    简介:我们对科学文献进行了为期20年的文献计量分析,关注国际功能分类的趋势,残疾与健康(ICF)在健康研究中的应用。
    方法:我们检索了2002年至2022年之间发布的3个467个文档,这些文档来自WebofScienceCoreCollection数据库。我们使用Bibliometrix和VoSviewer工具进行描述性分析和数据可视化。
    结果:我们的发现表明,自2011年以来,ICF的应用显着增加,年均增长率为13.19%。在全球范围内观察到了突出的贡献,来自美国的显著产出,加拿大,德国,荷兰,和瑞士。慕尼黑路德维希·马克西米利安大学,瑞士截瘫研究,麦克马斯特大学撰写了四分之一的文件(24.6%)。国家和机构的合作网络显示出强有力的伙伴关系,尤其是在德国和瑞士之间。“康复”是出现频率最高的关键词,尽管主题转向流行病学,老化,2020年后观察到与健康相关的生活质量。虽然康复仍然是主要的主题重点,2020年后的文献强调流行病学是一个越来越感兴趣的领域。
    结论:基于ICF的研究稳步增加,反映出人们对生物心理社会和以人为本的医疗保健方法的兴趣与日俱增。然而,文献主要是由高资源国家制作的,来自中低资源国家的代表性不足,建议未来的研究领域来解决这一差异。
    功能的国际分类,残疾与健康(ICF)是描述功能和残疾的通用框架。ICF在康复研究中的越来越多的应用强调了其在发展全面、以人为本的护理计划。通过整合ICF,康复计划可以更好地解决患者的多方面需求,促进改善参与和生活质量的结果。观察到的主题向2020年后老龄化和与健康相关的生活质量的转变表明,ICF在管理人口老龄化的复杂健康挑战方面的相关性日益增强。该研究还表明,在低收入和中等收入国家扩大ICF的实施可以弥合康复服务方面的现有差距,促进全球卫生公平。
    Introduction: We conducted a twenty-year bibliometric analysis of scientific literature, focusing on the trends of The International Classification of Functioning, Disability and Health (ICF) use in health research.
    Methods: We retrieved 3\'467 documents published between 2002 and 2022, sourced from the Web of Science Core Collection database. We used the Bibliometrix and VoSviewer tools for descriptive analyses and data visualization.
    Results: Our findings indicate a significant increase in ICF application since 2011, with an average annual growth rate of 13.19%. Prominent contributions were observed globally, with notable outputs from the U.S., Canada, Germany, the Netherlands, and Switzerland. The Ludwig Maximilian University Munich, Swiss Paraplegic Research, and McMaster University authored a quarter of the documents (24.6%). Collaboration networks of countries and institutions revealed robust partnerships, particularly between Germany and Switzerland. \"Rehabilitation\" was the most frequently occurring keyword, although a thematic shift towards epidemiology, aging, and health-related quality of life was observed post-2020. While rehabilitation remained the primary thematic focus, literature post-2020 highlighted epidemiology as a growing area of interest.
    Conclusions: A steady increase in ICF-based research mirrors the rising interest in a biopsychosocial and person-centered approach to healthcare. However, the literature is primarily produced by high-resource countries, with underrepresentation from low and middle-resource countries, suggesting an area of future research to address this discrepancy.
    The International Classification of Functioning, Disability and Health (ICF) serves as a universal framework for describing functioning and disability.The increasing application of the ICF in rehabilitation research underscores its value in developing comprehensive, person-centered care plans.By integrating the ICF, rehabilitation programs can better address the multifaceted needs of patients, facilitating improved outcomes in participation and quality of life.The observed thematic shift towards aging and health-related quality of life post-2020 indicates the growing relevance of the ICF in managing the complex health challenges of an aging population.The study also suggests that expanding the ICF implementation in low- and middle-income countries could bridge existing disparities in rehabilitation services, promoting global health equity.
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  • 文章类型: Journal Article
    目的:分析临床,神经认知,以及根据性别对首发精神病(FEP)患者催乳素水平的功能影响。
    方法:我们测量了221例用抗精神病药(AP)治疗的非情感性FEP患者和224例健康对照者的催乳素水平,在基线和2年随访。我们检查了临床变量和功能变量之间的关系是否由催乳素介导,控制抗精神病药的使用,根据性别。
    结果:在两个时间点,患者的催乳素水平均高于对照组。与催乳素相关的基线因素是氯丙嗪当量,注意,和执行功能。在FEP组中,催乳素水平与男性的功能和表达减少有关,和女性的工作记忆。催乳素水平(p=0.0134)仅在基线时的FEP男性患者中在阴性症状学(p=0.086)和功能结果(p=0.008)之间起中介作用。
    结论:催乳素在FEP患者的功能和临床症状中起作用。我们的结果表明,在基线和阴性症状下,高泌乳素血症患者的药物咨询可能会改善其功能和临床结局。
    OBJECTIVE: To analyze the clinical, neurocognitive, and functional impact of prolactin levels according to sex in patients with a First Episode Psychosis (FEP).
    METHODS: We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex.
    RESULTS: Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline.
    CONCLUSIONS: Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.
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  • 文章类型: Journal Article
    背景:神经认知缺陷已在临床精神病(CHR)高危人群中得到广泛报道。此外,CHR青年的大麻使用率很高,并且与更严重的症状有关。在更多进展的精神病队列中,大麻的使用有时被证明与更好的神经认知相关,因此,在这项研究中,我们旨在确定CHR中是否存在类似的模式.
    方法:来自北美前驱纵向研究(NAPLS-3)(N=698)的年龄为12-30岁的CHR参与者根据以下方面进行分组:“最少使用大麻”(n=406),“偶尔使用”(n=127),或“频繁使用”(n=165)。在基线,使用大麻的群体在神经认知测试中进行了比较,临床,和功能措施。后续分析用于模拟大麻使用频率之间的关系,神经认知,病前,和社会功能。
    结果:偶尔使用大麻的人在智商方面的表现明显优于其他使用群体,在神经认知领域观察到相似的趋势水平模式。偶尔大麻使用者表现出更好的社交能力,全球,与其他使用组相比,病前功能正常,与频繁使用组相比,症状较轻。后续结构方程建模/路径分析发现,病前功能之间存在显着的正相关关系,社会功能,和IQ,这反过来又与偶尔使用大麻的频率有关。
    结论:更好的病前功能积极预测更好的社会功能和更高的智商,这反过来又与CHR的适度大麻使用模式有关。与首发和慢性精神病样本的报告相似。更好的病前功能可能代表CHR人群的保护因素,并预测更好的功能结果。
    BACKGROUND: Neurocognitive deficits have been widely reported in clinical high-risk for psychosis (CHR) populations. Additionally, rates of cannabis use are high among CHR youth and are associated with greater symptom severity. Cannabis use has been sometimes shown to be associated with better neurocognition in more progressed psychosis cohorts, therefore in this study we aimed to determine whether a similar pattern was present in CHR.
    METHODS: CHR participants ages 12-30 from the North American Prodromal Longitudinal Study (NAPLS-3) (N = 698) were grouped according to: \"minimal to no cannabis use\" (n = 406), \"occasional use\" (n = 127), or \"frequent use\" (n = 165). At baseline, cannabis use groups were compared on neurocognitive tests, clinical, and functional measures. Follow-up analyses were used to model relationships between cannabis use frequency, neurocognition, premorbid, and social functioning.
    RESULTS: Occasional cannabis users performed significantly better than other use-groups on measures of IQ, with similar trend-level patterns observed across neurocognitive domains. Occasional cannabis users demonstrated better social, global, and premorbid functioning compared to the other use-groups and less severe symptoms compared to the frequent use group. Follow-up structural equation modeling/path analyses found significant positive associations between premorbid functioning, social functioning, and IQ, which in turn was associated with occasional cannabis use frequency.
    CONCLUSIONS: Better premorbid functioning positively predicts both better social functioning and higher IQ which in turn is associated with a moderate cannabis use pattern in CHR, similar to reports in first-episode and chronic psychosis samples. Better premorbid functioning likely represents a protective factor in the CHR population and predicts a better functional outcome.
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