The impact of affective and negative symptoms on the development of psychosis in a six-year follow-up of a community-based population.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2024-11-07 DOI:10.1007/s00127-024-02785-0

Ceylan Ergül, Tolga Binbay, Umut Kırlı, Hayriye Elbi, Köksal Alptekin, Jim van Os, Marjan Drukker

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Abstract

Purpose: The Clinical High Risk (CHR) concept has a limited transition risk to psychotic disorders (PD). This study investigates the association between affective and negative symptoms, currently not included in the CHR concept, and the risk of transition to PD in a community-based population of 2185 participants in Turkey.

Methods: Participants were assessed twice over six years using a multistage sampling technique. Two separate linear regression analyses were conducted on data from both assessments, investigating the relationship between affective and negative symptoms, subclinical and clinical psychotic experiences (PE) and progression to PD.

Results: The overall transition rate to PD was 1.3%. The analysis showed no increased risk of developing PD for the 'subclinical PE only' group at follow-up, compared to the 'no PE' group. However, being classified as having 'clinical PE only' (OR: 6.23; p = 0.010) and 'clinical PE + affective/negative symptoms' (OR: 8.48; p = 0.001) at baseline was associated with an increased risk of developing PD at follow-up. The presence of 'affective/negative symptoms' at baseline was associated with an increased risk of incident subclinical PE (RR: 1.98; p = 0.001), incident clinical PE (RR: 3.14; p = 0.001), and incident PD (RR: 4.21; p = 0.030) at follow-up.

Conclusion: The results confirm the significance of the baseline severity of positive symptoms in predicting the transition to PD and suggest that both positive and affective/negative symptoms impact the transition risk to PD and incident psychotic symptoms. This highlights the potential utility of defining CHR groups based on a combination of positive, affective, and negative symptoms.

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在对社区人群进行的六年跟踪调查中，情感症状和消极症状对精神病发展的影响。

目的：临床高风险（CHR）概念中，精神病性障碍（PD）的转归风险有限。本研究调查了目前未纳入临床高风险概念的情感症状和阴性症状与过渡到精神病性障碍的风险之间的关系：采用多阶段抽样技术，在六年内对参与者进行了两次评估。对两次评估的数据分别进行了两次线性回归分析，研究情感症状和阴性症状、亚临床和临床精神病经历（PE）与向帕金森病发展之间的关系：结果：转为帕金森病的总比率为 1.3%。分析结果表明，与 "无临床精神病经历 "组相比，"仅有亚临床精神病经历 "组在随访时发展为精神障碍的风险并没有增加。然而，基线时被归类为 "仅有临床 PE"（OR：6.23；p = 0.010）和 "临床 PE + 情感/阴性症状"（OR：8.48；p = 0.001）与随访时罹患帕金森病的风险增加有关。基线时存在 "情感/阴性症状 "与随访时发生亚临床 PE（RR：1.98；p = 0.001）、临床 PE（RR：3.14；p = 0.001）和 PD（RR：4.21；p = 0.030）的风险增加有关：结果证实，阳性症状的基线严重程度在预测向帕金森病转变方面具有重要意义，并表明阳性症状和情感/阴性症状都会影响向帕金森病转变的风险和精神病性症状的发生。这凸显了根据阳性、情感性和阴性症状的组合来定义CHR群体的潜在效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.