並列タイトル等Psychopathology and clinical outcomes of first-visit outpatients under 20 years old exhibiting a psychotic state
タイトル（掲載誌）琉球医学会誌 = Ryukyu Medical Journal
一般注記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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受理日（W3CDTF）2022-08-08T06:02:54+09:00
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