CAJ | 학술논문

背景：精神疾病未经治疗的时间和长期临床结局之间关系仍然存在争议。 　　目标：前瞻性评估浦东精神卫生中心2007年1月至2008年12月收治的首发精神分裂症患者未经治疗的时间与临床结果之间的关系。 　　方法：采用简明精神病评定量表（BPRS）、不良反应量表（TESS）、康复状态量表（MRSS）、以及社会功能缺陷筛选量表（SDSS）分别于基线、2010年6月和2012年6月收集一般健康状况，精神症状和社会功能相关信息。 　　结果：共43例首发精神分裂症患者参与研究，将其分为精神疾病未治疗（DUP）短期（≤24周）和精神疾病未治疗（DUP）长期（>24周）两组。短期DUP组的平均随访时间为1197（SD=401）天，长期DUP组平均随访时间为1412（SD=306）天（t=9.98，p=0.055）。尽管初诊时长期DUP组患者的精神病性症状较短期DUP组不明显（ BPRS平均分，42.5[8.4] v.50.0[10.6]，t=2.42，p=0.0210），并且两组临床复发次数类似（基于BPRS阳性症状量表评估），长期DUP组患者更可能在初诊时需要住院治疗（52%[11/21] v.9%[2/22]，χ2=9.55，p=0.002），并且在治疗的头两年更有可能再次住院（67%[14/21] v.32%[7/22]，χ2=5.22， p=0.022）。另外，经过四年的常规治疗后，虽然两组患者的阳性症状严重程度类似，但是治疗前具有较长DUP的患者比DUP较短的患者社会功能减退更明显。（SDSS平均，7.0[5.2] v.3.4[4.9]，t=2.20, p=0.035）。结论：这些结果表明，与治疗前DUP较短的精神分裂症患者相比，尽管DUP较长的患者精神病性症状的严重程度类似（由BPRS测量），但长期社会功能较差。这证实了对慢性精神障碍患者早期识别和及时治疗的临床重要性。
배경：정신질병미경치료적시간화장기림상결국지간관계잉연존재쟁의。 　　목표：전첨성평고포동정신위생중심2007년1월지2008년12월수치적수발정신분렬증환자미경치료적시간여림상결과지간적관계。 　　방법：채용간명정신병평정량표（BPRS）、불량반응량표（TESS）、강복상태량표（MRSS）、이급사회공능결함사선량표（SDSS）분별우기선、2010년6월화2012년6월수집일반건강상황，정신증상화사회공능상관신식。 　　결과：공43례수발정신분렬증환자삼여연구，장기분위정신질병미치료（DUP）단기（≤24주）화정신질병미치료（DUP）장기（>24주）량조。단기DUP조적평균수방시간위1197（SD=401）천，장기DUP조평균수방시간위1412（SD=306）천（t=9.98，p=0.055）。진관초진시장기DUP조환자적정신병성증상교단기DUP조불명현（ BPRS평균분，42.5[8.4] v.50.0[10.6]，t=2.42，p=0.0210），병차량조림상복발차수유사（기우BPRS양성증상량표평고），장기DUP조환자경가능재초진시수요주원치료（52%[11/21] v.9%[2/22]，χ2=9.55，p=0.002），병차재치료적두량년경유가능재차주원（67%[14/21] v.32%[7/22]，χ2=5.22， p=0.022）。령외，경과사년적상규치료후，수연량조환자적양성증상엄중정도유사，단시치료전구유교장DUP적환자비DUP교단적환자사회공능감퇴경명현。（SDSS평균，7.0[5.2] v.3.4[4.9]，t=2.20, p=0.035）。결론：저사결과표명，여치료전DUP교단적정신분렬증환자상비，진관DUP교장적환자정신병성증상적엄중정도유사（유BPRS측량），단장기사회공능교차。저증실료대만성정신장애환자조기식별화급시치료적림상중요성。
Background:The relaitonship between the duraiton of untreated psychosis and long-term clinical outcomes remains uncertain. Objecitve:Prospecitvely assess the relaitonship of the duraiton of untreated psychosis on clinical outcomes in a sample of individuals with ifrst-onset schizophrenia treated at the Pudong Mental Health Center from January 2007 to December 2008. Methods:Information about general health, psychotic symptoms and social functioning were collected using the Brief Psychiatric Rating Scale (BPRS), Treatment Emergent Symptom Scale (TESS), Morningside Rehabilitaiton Status Scale (MRSS), and Social Disability Screening Schedule (SDSS) at baseline and in June 2010 and June 2012. Results:The 43 individuals with ifrst-episode schizophrenia paritcipaitng in the study were divided into short (≤24 weeks) and long (>24weeks) duraiton of untreated psychosis (DUP) groups. The mean (sd) duraiton of follow-up was 1197 (401) days in the short DUP group and 1412 (306) days in the long DUP group (t=9.98, p=0.055). Despite less prominent psychoitc symptoms at the itme of ifrst diagnosis among paitents who had a long DUP compared to those with a short DUP (BPRS mean scores, 42.5 [8.4] v. 50.0 [10.6], t=2.42, p=0.0210) and a similar number of clinical relapses (based on posiitve symptoms assessed by the BPRS), paitents with a long DUP were more likely to require hospitalizaiton at the itme of ifrst diagnosis (52%[11/21] v. 9%[2/22],χ2=9.55, p=0.002) and more likely to require re-hospitalizaiton during the ifrst two years of treatment (67%[14/21] v. 32%[7/22],χ2=5.22, p=0.022). Moreover, after four years of routine treatment, despite a similar severity of posiitve symptoms, paitents who had had a long DUP prior to iniitaitng treatment had signiifcantly poorer social funcitoning than those who had had a short DUP (SDSS mean scores, 7.0 [5.2] v. 3.4 [4.9], t=2.20, p=0.035). Conclusions:These ifndings show that despite having a similar level of psychoitc symptoms-as measured by the BPRS-compared to paitents with a short DUP, paitents with schizophrenia who have a long DUP prior to iniital treatment have poorer long-term social funcitoning. This conifrms the clinical importance of the early recogniiton and treatment of individuals with chronic psychoitc condiitons.