Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis

JOURNAL OF AFFECTIVE DISORDERS

卷:203

Article

Rutigliano, Grazia^1,2  Valmaggia, Lucia^1,3  Landi, Paola^1,2  Frascarelli, Marianna^1,4  Cappucciati, Marco^1,5  Sear, Victoria³  Rocchetti, Matteo^1,5  De Micheli, Andrea^1,5  Jones, Ceri¹  Palombini, Erika^1,5  McGuire, Philip^1,3  Fusar-Poli, Paolo^1,3 

[1] Kings Coll London, Inst Psychiat Psychol & Neurosci, London, England

[2] Univ Pisa, Dept Clin & Expt Med, Pisa, Italy

[3] South London & Maudsley NHS Fdn Trust, OASIS Team, London, England

[4] Sapienza Univ Rome, Dept Neurol & Psychiat, Rome, Italy

[5] Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy

关键词: UHR;    Comorbid;    Global functioning;    Remission;    Outcomes;   

DOI  :  10.1016/j.jad.2016.05.053

来源: Elsevier

【 摘 要 】

Background: Patients at ultra-high risk for psychosis (UHR) are a highly heterogeneous group in terms of clinical and functional outcomes. Several non-psychotic mental disorders co-occur together with the UHR state. Little is known about the impact of non-psychotic comorbid mental disorders on clinical and functional outcomes of UHR patients. Methods: The sample included 154 UHR help-seeking patients (identified with the CAARMS, comprehensive assessment of the at-risk mental state), evaluated at baseline on the Ham-D, Ham-A (Hamilton depression/anxiety rating scale), and PANSS (positive and negative syndrome scale). 74 patients completed the 6-year follow-up assessment (mean=6.19, SD=1.87). Comorbid disorders at follow-up were assessed with the SCID I and II. Global functioning was rated on the global assessment of functioning (GAF) scale. Results: In the present sample, 6-year risk of psychosis transition was 28.4%. Among non-transitioned UHR patients, 283% reported attenuated psychotic symptoms (APS) and 45.3% remained functionally impaired at follow-up (GAF < 60). 56.8% patients were affected by at least one comorbid disorder at follow-up. Among UHR patients who presented with some comorbid disorder at baseline, 61.5% had persistent or recurrent course. Incident comorbid disorders emerged in 45.4% of baseline UHR patients. The persistence or recurrence of non-psychotic comorbid mental disorders was associated with poorer global functional outcomes at follow-up. Limitations: A substantial proportion of the initial sample was not available for follow-up interviews and some groups in the analyses had small sample size. Predictors of longitudinal outcomes were not explored. Conclusions: Among UHR patients, persistence or recurrence of non-psychotic comorbid mental disorders, mostly affective disorders, is associated with 6-year poor functional outcomes. (C) 2016 Elsevier B.V. All rights reserved.

【 授权许可】

Free