急性和短暂性精神障碍首发患者向精神分裂症和其他长期非情感性精神病过渡的预测因素:一项验证研究

IF 2.5 4区 医学 Q2 PSYCHIATRY European Journal of Psychiatry Pub Date : 2023-12-02 DOI:10.1016/j.ejpsy.2023.100234
Álvaro López-Díaz , José Luis Fernández-González , Ignacio Lara , Benedicto Crespo-Facorro , Miguel Ruiz-Veguilla
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引用次数: 0

摘要

背景和目的几乎有一半的初次精神病患者最初符合急性和短暂性精神障碍(ATPD)的标准,在随访期间将进行诊断修改,主要针对精神分裂症。本研究旨在确定首发ATPD患者诊断转变为精神分裂症和其他长期非情感性精神病的比例,并检验现有预测因素在这一人群中诊断转变的有效性。方法对首发ATPD患者设计了一项为期两年的前瞻性随访研究。进行了多变量逻辑回归分析,以确定与诊断过渡到持续非情感性精神病相关的独立变量。该预测模型是根据临床知识选取变量建立的。结果68例首发ATPD患者完成了研究,30例患者在随访结束时需要进行诊断修改,其中46.7%的患者转变为长期非情感性精神障碍。不良的病前调整和精神病发病时精神分裂症样症状的存在是唯一与诊断过渡到持续性非情感性精神病相关的独立显著变量。结论:我们的研究结果将有助于早期识别那些ATPD患者,他们最有可能发展为长期非情感性精神障碍,因此应该针对他们进行强化预防干预。
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Predictors of transition to schizophrenia and other long-lasting non-affective psychoses in first-episode patients with acute and transient psychotic disorders: A validation study

Background and objectives

Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population.

Methods

We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge.

Results

Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses.

Conclusion

Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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