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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >When to initiate antipsychotic treatment for psychotic symptoms: At the premorbid phase or first episode of psychosis?
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When to initiate antipsychotic treatment for psychotic symptoms: At the premorbid phase or first episode of psychosis?

机译：何时启动精神病症状的抗精神病药症状：在预血基阶段或精神病的第一集？

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摘要

Objective: Antipsychotic drugs are widely used for treating patients with first episode of psychosis, targeting threshold psychotic symptoms. The clinical high risk of psychosis is characterized as subthreshold psychotic symptoms and it is unclear whether they can also benefit from antipsychotic drugs treatment. This study attempted to determine whether initiating antipsychotic drugs treatment in the clinical high risk of psychosis phase was superior to initiating antipsychotic drugs treatment in the first episode of psychosis phase, after the 2-year symptomatic and functional outcomes. Method: Drawing on 517 individuals with clinical high risk of psychosis from the ShangHai At Risk for Psychosis program, we identified 105 patients who converted to first episode of psychosis within the following 2?years. Patients who initiated antipsychotic drugs while at clinical high risk of psychosis (CHR_AP; n ?=?70) were compared with those who initiated antipsychotic drugs during a first episode of psychosis (FEP_AP; n ?=?35). Summary scores on positive symptoms and the global function scores at baseline and at 2?months, 1?year and 2?years of follow-up were analyzed to evaluate outcomes. Results: The CHR_AP and FEP_AP groups were not different in the severity of positive symptoms and functioning at baseline. However, the CHR_AP group exhibited significantly more serious negative symptoms and total symptoms than the FEP_AP group. Both groups exhibited a significant reduction in positive symptoms and function ( p ?
机译：目的：抗精神病药物被广泛用于治疗首发精神病患者，针对临界精神病症状。精神病的临床高风险表现为阈下精神病症状，目前尚不清楚这些症状是否也能从抗精神病药物治疗中获益。这项研究试图确定，在2年的症状和功能结果之后，在精神病临床高危期开始抗精神病药物治疗是否优于在精神病第一期开始抗精神病药物治疗。方法：从上海精神病高危人群项目中抽取517名精神病临床高危人群，我们确定了105名在以下2年内转为精神病首发的患者？年。在临床上有精神病高风险（CHR_AP；n？=？70）的情况下服用抗精神病药物的患者与在精神病首次发作时服用抗精神病药物的患者（FEP_AP；n？=？35）进行比较。基线检查时和第2次检查时的阳性症状汇总得分和整体功能得分？几个月，1个月？第二年？分析多年的随访结果。结果：CHR_AP组和FEP_AP组在阳性症状的严重程度和基线检查时的功能方面没有差异。然而，CHR_AP组比FEP_AP组表现出更严重的阴性症状和总症状。两组患者的阳性症状和功能均显著降低（p<0.001）。重复测量方差分析揭示了症状（F？=？3.196，df？=？3，p？=？0.024）和功能评分（F？=？7.306，df？=？3，p？<？0.001）的逐时交互作用。FEP_AP组的缓解率高于CHR_AP组（χ2）？=？22.270页？0.001). 与在精神病临床高危状态下开始抗精神病药物治疗相比，在精神病状态的第一次发作时开始抗精神病药物治疗在FEP_AP的回归模型中预测病情缓解（优势比？=？5.567，95%可信区间？=？[1.783，17.383]，p？=？0.003）。结论：对于精神病临床高危人群，抗精神病药物可能不是长期缓解的首选药物，在精神病第一发作期使用更为合理。

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  • 作者

    TianHong Zhang; LiHua Xu; YanYan Wei; XiaoChen Tang; YeGang Hu; HuiRu Cui; YingYing Tang; Bin Xie; ChunBo Li; JiJun Wang;

  • 作者单位

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

    Shanghai Key Laboratory of Psychotic Disorders Shanghai Mental Health Center Shanghai Jiaotong;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经病学与精神病学;
  • 关键词

    Ultra high risk; clinical high risk for psychosis; transition; medication; outcome;

    机译：超高风险;精神病的临床高风险;过渡;药物;结果;

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