临床和亚临床精神病患者的功能恢复与临床,神经心理和发育因素。关于这些因素如何预测相同模型中的功能结果,人们知之甚少。我们调查了首发精神病(FEP)或确诊或未确诊临床精神病高风险患者的功能结局及其预测因素(CHR-Pvs.CHR-N)。
总之,130名FEP患者,招募60例CHR-P患者和47例CHR-N患者,并在基线(T0)和9(T1)和18(T2)个月后进行广泛检查。T0,T1和T2和精神病患者的全球功能评估(GAF)抑郁症,评估T1和T2时的焦虑症状。使用多变量重复ANOVA预测功能结果。
随访期间,FEP和CHR-P患者的GAF评分显着改善,而CHR-N患者则无改善。单一的婚姻状况,基础教育水平低,恶劣的工作环境,紊乱症状,知觉缺陷,FEP患者的病前调整效果不佳,CHR-P患者的紊乱症状和病前调整不良,基础教育水平低,CHR-N患者的不良工作状况和一般症状预示着不良的功能结局.FEP患者T1时的精神病症状,CHR-P患者T1时的精神病和抑郁症状以及T2时的焦虑症状与功能不良有关。
在FEP和CHR-P患者中,不良的病前调整和无序症状学是功能结局的常见预测因子,而低教育水平和不良的工作状况预测FEP和CHR-N患者的功能预后较差。旨在提高工作和学习能力的干预措施对于改善临床或亚临床精神病患者的功能至关重要。
Functional recovery of patients with clinical and subclinical psychosis is associated with clinical, neuropsychological and developmental factors. Less is known about how these factors predict functional outcomes in the same models. We investigated functional outcomes and their predictors in patients with first-episode psychosis (FEP) or a confirmed or nonconfirmed clinical high risk of psychosis (CHR-P vs. CHR-N).
Altogether, 130 patients with FEP, 60 patients with CHR-P and 47 patients with CHR-N were recruited and extensively examined at baseline (T0) and 9 (T1) and 18 (T2) months later. Global Assessment of Functioning (GAF) at T0, T1 and T2 and psychotic, depression, and anxiety symptoms at T1 and T2 were assessed. Functional outcomes were predicted using multivariate repeated ANOVA.
During follow-up, the GAF score improved significantly in patients with FEP and CHR-P but not in patients with CHR-N. A single marital status, low basic education level, poor work situation, disorganization symptoms, perceptual deficits, and poor premorbid adjustment in patients with FEP, disorganization symptoms and poor premorbid adjustment in patients with CHR-P, and a low basic education level, poor work situation and general symptoms in patients with CHR-N predicted poor functional outcomes. Psychotic symptoms at T1 in patients with FEP and psychotic and depression symptoms at T1 and anxiety symptoms at T2 in patients with CHR-P were associated with poor functioning.
In patients with FEP and CHR-P, poor premorbid adjustment and disorganization symptomatology are common predictors of the functional outcome, while a low education level and poor work situation predict worse functional outcomes in patients with FEP and CHR-N. Interventions aimed at improving the ability to work and study are most important in improving the functioning of patients with clinical or subclinical psychosis.