2024-03-29T12:30:48Z
https://u-ryukyu.repo.nii.ac.jp/oai
oai:u-ryukyu.repo.nii.ac.jp:02016921
2022-02-22T07:20:06Z
1642838163960:1642838198944:1642838199408:1642838232560
1642838403551:1642838412624
Psychopathology and clinical outcomes of first-visit outpatients under 20 years old exhibiting a psychotic state
Ishibashi, Takao
Shinzato, Hotaka
Zamami, Yu
Shimabukuro, Morihiro
Kondo, Tsuyoshi
open access
琉球医学会
under 20
schizophrenia
at risk mental state
early symptoms
insight
outcome of patients under 20 years old exhibiting a psychotic state. Methods: Forty-five patients (15 males and 30 females) under 20 years old with a diagnostic description of psychosis, schizophrenia, at-risk mental state (ARMS) or psychotic-like experiences, who had first visited our clinic between January 2012 and December 2017 were retrospectively extracted from medical records. Their age at the onset of symptoms; psychiatric diagnoses, including comorbidities; insight of disease; symptomatology (early, positive, negative, catatonic and anxiety-depression symptoms); course of illness; prescribed medication; and final treatment outcome were investigated from various aspects. Results: Prodromal stages of schizophrenia (ARMS and early schizophrenia) were observed in about one-third of the overall patients. Patients with insight of disease had a higher baseline global assessment of functioning and greater number of early schizophrenic symptoms and anxiety-depression symptoms than those without insight of disease. In particular, early schizophrenic symptoms appear to be a discriminating factor for insight of disease. A total of 36.4% of ARMS patients converted to schizophrenia, while 25% of early schizophrenia patients converted to frank schizophrenia. Doses of antipsychotics (chlorpromazine equivalence: mg/day) were lower in ARMS non-converters (100±63) than in ARMS converters (364±44) or schizophrenics (477±337). Among overall patients, 62.3% showed improvement as the final treatment outcome. The global assessment of functioning values were higher at 6 (54.2%±17.2%) and 12 months (55.1%±18.9%) than that at baseline (34.1%±10.3%). Conclusion: The present study suggests that clinicians need to actively ask about early symptoms or attenuated positive symptoms in patients under 20 years old with a psychotic state who may still have insight of disease and encourage voluntary help-seeking. The first six months might be a critical period for achieving symptomatological remission and functional recovery in these patients.
論文
琉球医学会
Ryukyu Medical Association
eng
journal article
VoR
http://hdl.handle.net/20.500.12000/0002016921
https://u-ryukyu.repo.nii.ac.jp/records/2016921
1346-888X
AN10369445
琉球医学会誌 = Ryukyu Medical Journal
39
1-4
29
40
https://u-ryukyu.repo.nii.ac.jp/record/2016921/files/Vol39p29.pdf