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'Prodromal' diagnosis of psychosis: Ethical problems in research and clinical practice

机译:精神病的“前驱”诊断:研究和临床实践中的伦理问题

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Ethical concerns surrounding the identification of an 'at-risk' state for psychosis are long-standing. Two major risks are the stigmatisation/ labelling of those identified as being at risk of progression to psychosis, and unnecessary anxiety and demoralisation about prognosis. False-positive diagnosis of'psychosis risk syndrome' or'prodromal psychosis' can have lifelong detrimental social and psychological consequences. An even more serious risk is unnecessary pre-emptive use of antip-sychotics, with potentially serious side-effects, including weight gain, diabetes, metabolic syndrome (Foley and Morley,201 I),neurological symptoms, and brain shrinkage (Ho et al., 201 I). Although weight gain emerges rapidly, many of these adverse effects only emerge in the longer term.
机译:关于确定精神病处于“高风险”状态的伦理问题长期存在。两个主要风险是对被标识为有发展为精神病风险的人的污名化/标签化,以及对预后的不必要的焦虑和士气低落。对“精神病风险综合症”或“前驱性精神病”的假阳性诊断可能会终身损害社会和心理后果。更为严重的风险是不必要地过早使用抗精神病药,可能产生严重的副作用,包括体重增加,糖尿病,代谢综合征(Foley和Morley,201 I),神经系统症状和脑萎缩(Ho等)。 。,201 I)。尽管体重增加迅速出现,但许多这些不良反应只是从长远来看。

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