背景:最近的研究表明,临床精神病高风险(CHR-P)对精神病性障碍具有高度特异性,而不是对各种严重精神疾病的多潜能。然而,并非所有CHR-P都只发展为精神病,精神病也可以发生在非精神病性障碍中。我们的前瞻性队列研究旨在调查多能性高危人群的特征和临床结局,这些人群可能会发展出多种精神疾病。
方法:SPRIM研究是一项前瞻性自然队列计划,重点是早期发现有严重精神疾病风险的人。包括精神病(CHR-P),双极(CHR-B),和抑郁症(CHR-D),以及未分化风险参与者(UCHR)。我们的研究采用纵向设计,在6、12、18、24、30、36、42和48个月进行基线评估和8次随访评估,以确定参与者是否已过渡到精神病或情绪障碍。
结果:SPRIM样本由90名CHR参与者组成。总累积过渡发生率为53.3%(95%CI32.5-77.2)。CHR-P,CHR-B,CHR-D,UCHR的累积发病率为13.7%(95%CI3.4-46.4),52.4%(95%CI28.1-81.1),66.7%(95%CI24.6-98.6)和54.3%(95%CI20.5-93.1),分别。精神病的累积发病率,双极,所有参与者中的抑郁障碍为3.3%(95%CI0.8-11.5),45.7%(95%CI24.4-73.6),和11.2%(95%CI3.1-36.2),分别。
结论:我们的研究表明,对于不同范围的精神疾病而言,多能性高风险的概念是一种综合方法,可以以高转化率和最小化污名来检查疾病之间的跨诊断相互作用。
BACKGROUND: Recent studies have indicated that clinical high risk for psychosis (CHR-P) is highly specific for psychotic disorders other than pluripotential to various serious mental illnesses. However, not all CHR-P develop psychotic disorder only, and psychosis can occur in non-psychotic disorders as well. Our prospective cohort study aims to investigate the characteristics and clinical outcomes of a
pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders.
METHODS: The SPRIM study is a prospective naturalistic cohort program that focuses on the early detection of those at risk of developing serious mental illness, including psychosis (CHR-P), bipolar (CHR-B), and depressive disorder (CHR-D), as well as undifferentiated risk participants (UCHR). Our study has a longitudinal design with a baseline assessment and eight follow-up evaluations at 6, 12, 18, 24, 30, 36, 42, and 48 months to determine whether participants have transitioned to psychosis or mood disorders.
RESULTS: The SPRIM sample consisted of 90 CHR participants. The total cumulative incidence rate of transition was 53.3% (95% CI 32.5-77.2). CHR-P, CHR-B, CHR-D, and UCHR had cumulative incidence rates of 13.7% (95% CI 3.4-46.4), 52.4% (95% CI 28.1-81.1), 66.7% (95% CI 24.6-98.6) and 54.3% (95% CI 20.5-93.1), respectively. The cumulative incidence of psychosis, bipolar, and depressive disorder among all participants was 3.3% (95% CI 0.8-11.5), 45.7% (95% CI 24.4-73.6), and 11.2% (95% CI 3.1-36.2), respectively.
CONCLUSIONS: Our study suggests that the concept of
pluripotent high-risk for a diverse range of psychiatric disorders is an integrative approach to examining transdiagnostic interactions between illnesses with a high transition rate and minimizing stigma.