학술논문
최근 발병한 정신분열병 환자의 증상 관해 및 정신사회적 기능: 1년 전향적 추적 관찰 연구
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- 영문명
- Symptom Remission and Functional Outcomes in Patients with Recent-Onset Schizophrenia:A One-Year Prospective Observational Study
- 발행기관
- 대한신경정신의학회
- 저자명
- 정석훈 박원명 권준수 박지홍 안준호 고진경 김창윤
- 간행물 정보
- 『신경정신의학』제46권 제5호, 480~491쪽, 전체 12쪽
- 주제분류
- 의약학 > 정신과학
- 파일형태
- 발행일자
- 2007.09.30
4,240원
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국문 초록
영문 초록
Objectives:The long-term outcome of schizophrenia is still considered variable and inconclusive. We performed a one-year
prospective observational study to investigate the longitudinal outcomes in patients with recent-onset schizophrenia. The primary
purpose was to determine the descriptive outcomes in terms of symptom remission and psychosocial function. The secondary purpose was to identify predictor variables associated with the outcomes.
Methods:Patients experiencing their first episode of psychosis or hospitalization within the past 2 years with a diagnosis of DSM-IV schizophrenia were included. Clinical symptoms were assessed monthly using Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and Clinical Global Impression (CGI) scale. Psychosocial function was measured using PSYCH-UP (Psychosocial symptoms you currently have, follow-up version) and Heinrichs’ Quality of Life Scale (QLS) at baseline, 6, and 12 months and Global Assessment of Functioning (GAF) monthly. Remission was defined on the basis of overall, and psychotic core symptoms as having 1) BPRS total score ≤36, and 2) Each individual item score of core psychotic items (conceptual disorganization, suspiciousness, hallucinatory
behavior, unusual thought content) ≤3, and 3) CGI severity score ≤3, and 4) Duration of remission at least for 2 consecutive months. To identify the predictive variables for the outcome, relationships between time to remission and various clinical variables were examined using Cox proportional hazards model.
Results:A total of 49 patients with schizophrenia were enrolled in this study. The proportions of patients with symptom remission were 54.5% (24/44, drop outs=5) at 3 months, 55.3% (21/38, drop outs=11) at 6 months, and 64.3% (18/28, drop outs=21) at 12 months. Mean time to remission was 3.76±2.43 (s.d.) months, and the mean duration of remission was 7.54± 2.99 months. Significantly longer time to remission was predicted by higher SANS total score at baseline in various predictor variables (p=0.01). Impairments of psychosocial function measured using PSYCH-UP and QOL were significantly improved at the end of this study, but still remained at mild to moderate level. SANS total score and GAF score significantly correlated with
most of the items related to psychosocial function at 12 months. The proportion of the patients with GAF score ≥60 increased from 6.1% at baseline to 85.8% at 12 months. Of the patients who were in remission at 12 months, 95.5% obtained GAF score ≥60. Conclusion:This study showed 64.3% of symptom remission rate in patients with recent-onset schizophrenia. Symptom remission was accompanied by significant improvement of global function. The severity of negative symptom at baseline appeared to be a significant predictor for time to remission. Psychosocial function was improved at the end of this study, but impairments still remained at mild to moderate level. GAF score and negative symptoms significantly correlated with psychosocial function.
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REFERENCES
해당간행물 수록 논문
- 양극성 장애의 우세삽화와 임상양상 간의 연관성:예비연구
- 암 환자와 가족에 대한 정신의학적·심리사회적 개입
- 최근 발병한 정신분열병 환자의 증상 관해 및 정신사회적 기능: 1년 전향적 추적 관찰 연구
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- 조기 발병 양극성 장애 환자의 임상적 특징:후향적 의무기록 조사 연구
- 흰쥐에서 출생 전 Nitric Oxide Synthase 억제제의 노출이 출생 후 강제 수영 시의 행동 변화에 미치는 영향
- 경도인지장애(Mild Cognitive Impairment)에서 단축형 Samsung Dementia Questionnaire(S-SDQ)의 임상적 유용성
- 남성화 암쥐의 모리스 수중 미로 수행력: 성에 따른 공간기억력과 테스토스테론 효과의 차이
- 한국형 우울장애 약물치료 알고리듬 2006 (I)
- 알코올 의존 환자의 의사 결정에서의 보속적인 경향
- 정신증 환자의 증상과 기능에 대한 간략형 평가 척도의 타당도 및 신뢰도
- 한국형 우울장애 약물치료 알고리듬 2006 (II): 정신병적 양상을 동반하지 않은 주요우울장애의 약물치료
- 암 환자의 정신사회적 특성과 정신 건강
- 정신종양학의 역사와 현황
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