中学生精神病风险综合征的临床转归调查

Analysis on clinical outcomes for psychosis risk syndrome in middle school students

目的:调查中学生精神病风险综合征(PRS)的临床转归和临床特征。方法:本研究为小型前瞻性队列研究,利用精神病前驱期问卷16条目(PQ-16)在中山市中学生中进行精神病筛查,对59例符合PRS诊断标准的阳性者使用精神病风险综合征定式访谈(SIPS)评估基线和1年后的临床精神病理学特征,并分析PRS 1年的自然转归特征和临床精神病理特点。结果:45例完成1年后随访(76.3%),脱落14例。其中,11例转化为精神障碍,纳入转化组,转化率为24.4%;18例(40.0%)维持PRS诊断,纳入维持组;16例(35.6%)缓解,纳入缓解组。转化组比维持组和缓解组求助于精神心理机构更多、学校适应性更差、学习成绩更低和同伴关系更不良(P均<0.05)。转化组精神病风险症状量表(SOPS)各因子分与总分均高于维持组和缓解组,功能整体评定量表(GAF)总分低于维持组和缓解组(P均<0.05)。结论:中学生PRS 1年后转化为精神障碍风险较高,精神障碍转化者的社会功能损害和风险症状均较严重,需要早期识别和干预。

Objective:To investigate the clinical outcomes and psychopathological characteristics in middle school students with psychosis risk syndrome(PRS).Method:In the small prospective corhort study,fifty-nine middle school students with PRS were initially screened with 16-Item Version of the Prodromal Questionnaire(PQ-16),followed by the Structured Interview for Psychosis-Risk Syndrome(SIPS)with evaluating the psychopathological characteristics at both baseline and one year later.Results:Forty five students with PRS(76.3%)completed one-year following up.11 cases with PRS converted to mental disorders(conversion group)and the conversion rate reached 24.4%.18 cases(40.0%)(maintenance group)remainined diagnosed with PRS.16 cases(35.6%)(remission group)met the remission criteria.Increased rate of help-seeking behavior,impaired school adaptation,lower academic performance and worse peer relationships were found in the conversion group compared with the maintenance and recovery group(all P<0.05).Compared with the maintenance group and remission group,the factor scores for the Scale of Psychosis-Risk Symptoms(SOPS)and its total score in the conversion group were higher,while the score of Global Assessment of Functioning(GAF)was lower(all P<0.05).Conclusion:Middle school students with PRS have high risk of conversion to mental disorders after one year.Early identification and intervention is needed due to the impaired social function and high risk of psychosis onset in middle school student with PRS.