精神分裂症谱系中的假神经症状:精神分裂症谱系中的假性神经症症状:与精神病理学和临床结果关系的纵向研究》(A Longitudinal Study of Their Relation to Psychopathology and Clinical Outcomes.

IF 5.3 1区 医学 Q1 PSYCHIATRY Schizophrenia Bulletin Pub Date : 2024-07-27 DOI:10.1093/schbul/sbad185
Andreas Rosén Rasmussen, Peter Handest, Anne Vollmer-Larsen, Josef Parnas
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引用次数: 0

摘要

背景和假设:非精神病性症状(抑郁、焦虑、强迫等)在精神分裂症谱系障碍中很常见,通常被概念化为合并症或跨诊断症状。然而,在二十世纪的基础精神病理学文献中,许多具有特殊现象的非精神病性症状(此处称为假神经症状)被认为是精神分裂症的相对典型症状。在这项前瞻性研究中,我们调查了假性神经症状与精神分裂症的诊断状态、功能结果以及精神病理学方面的潜在关联:研究设计:我们对首次入院并被诊断为非情感性精神病、分裂型障碍或其他精神疾病的患者(N = 121)进行了初次住院和 5 年后的精神病理学综合评估。根据文献资料,我们构建了针对假性神经症症状和其他更普遍的非精神病性症状的量表:研究结果:与其他精神疾病相比,假神经症状在精神分裂症谱系群体中更为集中,并且在基线和随访中的出现程度相似。假神经症状可纵向预测精神分裂症谱系患者5年内较差的社会和职业功能,但不能预测患者从其他精神疾病转为精神分裂症谱系障碍。最后,假神经症状的程度与两次评估中的基本自我失调以及随访中的阳性和阴性症状相关。针对一般非精神病性症状的量表没有显示出这种关联模式:本研究证实,一组非精神病性症状,即假神经症状,与精神分裂症谱系障碍有关,并与时间上稳定的精神病理学,尤其是基本自我紊乱有关。这些症状与社会和职业功能的前瞻性关联还需要进一步证实。
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Pseudoneurotic Symptoms in the Schizophrenia Spectrum: A Longitudinal Study of Their Relation to Psychopathology and Clinical Outcomes.

Background and hypothesis: Nonpsychotic symptoms (depression, anxiety, obsessions, etc.) are frequent in schizophrenia-spectrum disorders and are usually conceptualized as comorbidity or transdiagnostic symptoms. However, in twentieth century foundational psychopathological literature, many nonpsychotic symptoms with specific phenomenology (here termed pseudoneurotic symptoms) were considered relatively typical of schizophrenia. In this prospective study, we investigated potential associations of pseudoneurotic symptoms with diagnostic status, functional outcome as well as psychopathological dimensions of schizophrenia.

Study design: First-admitted patients (N = 121) diagnosed with non-affective psychosis, schizotypal disorder, or other mental illness were examined at initial hospitalization and 5 years later with a comprehensive assessment of psychopathology. Informed by the literature, we constructed scales targeting pseudoneurotic symptoms and other, more general, nonpsychotic symptoms.

Study results: Pseudoneurotic symptoms aggregated in schizophrenia-spectrum groups compared to other mental illnesses and occurred at similar levels at baseline and follow-up. They longitudinally predicted poorer social and occupational functioning in schizophrenia-spectrum patients over a 5-year-period but not transition to schizophrenia-spectrum disorders from other mental illnesses. Finally, the level of pseudoneurotic symptoms correlated with disorder of basic self at both assessments and with positive and negative symptoms at follow-up. The scale targeting general nonpsychotic symptoms did not show this pattern of associations.

Conclusions: The study supports that a group of nonpsychotic symptoms, ie, pseudoneurotic symptoms, are associated with schizophrenia-spectrum disorders and linked with temporally stable psychopathology, particularly disorder of the basic self. Their prospective association with social and occupational functioning needs replication.

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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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