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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. 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精神病状態を呈した20歳未満の外来初診患者の精神病理と臨床転帰
http://hdl.handle.net/20.500.12000/0002018037
http://hdl.handle.net/20.500.12000/00020180379a9456e0-cca9-4e4a-b475-3cf69c8f26fc
名前 / ファイル | ライセンス | アクション |
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Item type | 琉球大学リポジトリ登録用アイテムタイプ(1) | |||||||||
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公開日 | 2022-06-13 | |||||||||
タイトル | ||||||||||
タイトル | Psychopathology and clinical outcomes of first-visit outpatients under 20 years old exhibiting a psychotic state | |||||||||
言語 | en | |||||||||
タイトル | ||||||||||
タイトル | 精神病状態を呈した20歳未満の外来初診患者の精神病理と臨床転帰 | |||||||||
言語 | ja | |||||||||
作成者 |
石橋, 孝勇
× 石橋, 孝勇
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アクセス権 | ||||||||||
アクセス権 | open access | |||||||||
アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | under 20 | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | schizophrenia | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | at risk mental state | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | early symptoms | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | insight | |||||||||
内容記述 | ||||||||||
内容記述タイプ | Abstract | |||||||||
内容記述 | Aim: This study aimed to clarify the psychopathology, global functioning and clinical 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. |
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言語 | en | |||||||||
出版者 | ||||||||||
言語 | ja | |||||||||
出版者 | 琉球大学 | |||||||||
出版者 | ||||||||||
言語 | en | |||||||||
出版者 | University of the Ryukyus | |||||||||
言語 | ||||||||||
言語 | eng | |||||||||
資源タイプ | ||||||||||
資源タイプ | doctoral thesis | |||||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||||
出版タイプ | ||||||||||
出版タイプ | VoR | |||||||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||||||
関連情報 | ||||||||||
識別子タイプ | HDL | |||||||||
関連識別子 | http://hdl.handle.net/20.500.12000/0002018035 | |||||||||
収録物識別子 | ||||||||||
収録物識別子タイプ | PISSN | |||||||||
収録物識別子 | 1346-888X | |||||||||
収録物識別子 | ||||||||||
収録物識別子タイプ | NCID | |||||||||
収録物識別子 | AN10369445 | |||||||||
収録物名 | ||||||||||
言語 | ja | |||||||||
収録物名 | 琉球医学会誌 = Ryukyu Medical Journal | |||||||||
書誌情報 |
巻 39, 号 1-4, p. 29-40 |
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学位授与番号 | ||||||||||
学位授与番号 | 甲第542号 | |||||||||
学位名 | ||||||||||
学位名 | 博士(医学) | |||||||||
言語 | ja | |||||||||
学位授与年月日 | ||||||||||
学位授与年月日 | 2022-03-18 | |||||||||
学位授与機関 | ||||||||||
学位授与機関識別子 | 18001 | |||||||||
学位授与機関識別子Scheme | kakenhi | |||||||||
学位授与機関名 | 琉球大学 | |||||||||
言語 | ja |