发展为严重精神疾病高风险的青少年的类精神病经历:两年以上的变化以及与神经奖励加工和情感症状的关联

IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY
Xiaoying Dong, Tina Gupta, Gretchen Haas, Kristen L Eckstrand, Jennifer S Silk, Neal D Ryan, Erika E Forbes
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引用次数: 0

摘要

类似精神病的经历(ple)——类似精神病的亚临床经历或症状,如幻觉和妄想——通常出现在青春期,预示着严重的精神病理。了解青春期的ple是至关重要的,因为神经奖励系统的共同发生的发育变化增加了精神相关和情感性精神病理的风险,特别是那些有严重精神疾病家族史的人。在这个关键的发育时期,我们研究了ple、临床症状和神经奖励功能之间的关系。在两年多的时间里,117名重度精神障碍高风险(n = 74)或低风险(n = 43)的青少年(基线年龄为13-19岁),基于情感或精神障碍的家族史,每年完成症状问卷调查,并在研究开始时在猜测奖励任务期间进行功能磁共振成像扫描。我们评估了两年内ple的变化,并评估了临床症状(焦虑、抑郁、快感缺乏)和对背内侧前额叶皮层(dmPFC)和腹侧纹状体(VS)奖励的反应是否能预测两年后的ple。随着时间的推移,ple总分和痛苦程度增加,高风险组的ple上升幅度大于低风险组。基线时右VS神经激活升高和焦虑升高(但不包括左VS或dmPFC神经激活、抑郁或快感缺乏)预示24个月时ple升高。对外界刺激的高度警惕和敏感性可能是青少年ple发展的重要先兆。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychotic-like experiences in adolescents enriched for high-risk for developing severe mental illness: change over two-years and associations with neural reward processing and affective symptoms.

Psychotic-like experiences (PLEs) -subclinical experiences or symptoms that resemble psychosis, such as hallucinations and delusional thoughts-often emerge during adolescence and are predictive of serious psychopathology. Understanding PLEs during adolescence is crucial due to co-occurring developmental changes in neural reward systems that heighten the risk for psychotic-related and affective psychopathology, especially in those with a family history of severe mental illness (SMI). We examined associations among PLEs, clinical symptoms, and neural reward function during this critical developmental period. Over two-years, 117 adolescents (aged 13-19 years at baseline) at high-risk (n = 74) or low-risk (n = 43) for SMI based on family history of affective or psychotic disorder completed symptom questionnaires annually and fMRI scanning at study entry during a guessing reward task. We assessed changes in PLEs over two-years and evaluated whether clinical symptoms (anxiety, depression, anhedonia) and response to rewards of the dorsal medial prefrontal cortex (dmPFC) and ventral striatum (VS) predicted PLEs two-years later. PLEs total scores and distress increased over time, with the high-risk group showing a greater rise in PLEs than the low-risk group. Heightened right VS neural activation and higher anxiety at baseline (but not left VS or dmPFC neural activation, depression, or anhedonia) predicted more PLEs at 24-months. Heightened vigilance and sensitivity to external stimuli may be important precursors to the development of PLEs for adolescents.

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来源期刊
CiteScore
8.80
自引率
4.30%
发文量
154
审稿时长
6-12 weeks
期刊介绍: The original papers published in the European Archives of Psychiatry and Clinical Neuroscience deal with all aspects of psychiatry and related clinical neuroscience. Clinical psychiatry, psychopathology, epidemiology as well as brain imaging, neuropathological, neurophysiological, neurochemical and moleculargenetic studies of psychiatric disorders are among the topics covered. Thus both the clinician and the neuroscientist are provided with a handy source of information on important scientific developments.
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