未经治疗的精神病持续时间对首发精神分裂症短期疗效的影响

B. K, P. K., B. K, P. D
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摘要

目的:精神分裂症是一种破坏性疾病,许多患者由于家人难以识别症状而迟迟得不到治疗。本研究的目的是找出精神病未治疗时间较长(DUP)与首发精神分裂症患者治疗效果不佳之间是否存在关联,以及病前社会适应与 DUP 之间是否存在关联:方法:在首次住院治疗 12 周后,对未服用抗精神病药物的国际疾病分类-10 型精神分裂症患者进行评估。通过临床访谈考察了未经治疗的初始精神病持续时间(从首次出现症状和首次入院开始测量)、症状严重程度(通过阳性和阴性综合征量表和临床总体印象量表测量)、病前社会适应(通过病前社会适应(PSA)量表测量)和治疗后症状改善(通过CGI-I量表测量)之间的关系:在研究的57名患者中,57.9%的患者在治疗后症状有所改善,偏执型患者更常见,联合使用典型和非典型抗精神病药物治疗的患者反应更好,DUP小于2年的患者症状改善更好。阳性综合征评分与 DUP 呈显著负相关。DUP与阴性综合征评分、精神病理学评分和PSA评分没有关联:结论:DUP 是治疗结果的独立预测因子,要想获得更好的预后,必须尽早干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
INFLUENCE OF DURATION OF UNTREATED PSYCHOSIS ON THE SHORT-TERM OUTCOME IN FIRST-EPISODE SCHIZOPHRENIA
Objectives: Schizophrenia is a devastating disease and many patients present late for treatment due to difficulty in identifying symptoms by family members. The objective of this study is to find if there is an association between a longer duration of untreated psychosis (DUP) and poor treatment outcome in first-episode Schizophrenics and to find if there is an association between premorbid social adjustment on DUP. Methods: Anti-psychotic-naïve patients with an international classification of diseases-10 schizophrenia were evaluated 12 weeks after their first in-patient hospitalization. Association between untreated initial psychosis duration (measured from the beginning of first symptom as well as from first hospital admission) was examined by conducting the clinical interview, symptom severity by positive and negative syndrome scale, and clinical global impression scale, pre-morbid social adjustment by premorbid social adjustment (PSA) scale; and symptoms improvement after treatment by CGI-I scale. Results: Of the 57 patients studied, 57.9% showed improvement after treatment, paranoid type was more common, patients responded better when treated with combined typical and atypical antipsychotics and improvement was better when DUP was <2 years. There was a major negative correlation between positive syndrome scores and DUP. There was no association of DUP with negative syndrome score, psychopathology score and PSA score. Conclusion: DUP was an independent predictor of treatment outcome and early intervention is necessary for better prognosis.
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