严重精神障碍的跨诊断性前兆:电子健康记录研究
Maite Arribas1, Dominic Oliver2,3,4,5, Rashmi Patel6
1Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK. maite.arribas@kcl.ac.uk.
Molecular psychiatry
|May 6, 2024
概括
严重精神障碍 (SMD) 预发症在单极情绪障碍,双极情绪障碍和精神病障碍之间在持续时间和表现方面存在很小的差异. 大多数前发性特征是跨诊断的,在发病前加剧,支持统一的预防策略.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 流行病学 流行病学
- 在医疗保健中的数据科学.
背景情况:
- 有效预防严重精神障碍 (SMD) 需要了解前兆阶段.
- 产物阶段包括持续时间,第一次呈现,时间过程和跨诊断性.
- 在不同类别的中小企业中比较这些特征时,存在知识差距.
研究的目的:
- 为了比较单极性情绪障碍 (UMD),双极性情绪障碍 (BMD) 和精神病障碍 (PSY) 的前兆阶段的持续时间,首次呈现,时间进程和跨诊断性.
- 识别潜在的跨诊断特征,以开发统一的预防服务.
主要方法:
- 使用电子健康记录进行的回顾性队列研究 (N=26,975).
- 自然语言处理以提取65个月的前性特征,分为八个集群.
- 包括ANOVA,科恩d和线性混合效应模型在内的统计分析,以比较中小企业群体之间的产物特征.
主要成果:
- UMD预症持续时间 (18个月) 比BMD (26个月) 和PSY (24个月) 短.
- 大多数个体呈现出多个,非特异性的前性.
- 积极的症状是唯一的第一个产物集群,在组之间有中等规模的差异.
- 随着SMD发病的临近,prodromal集群的发生率增加.
- 大多数前兆特征是跨诊断的,除了积极的症状.
结论:
- 在二级精神卫生保健中,UMD,BMD和PSY的前发症的持续时间和第一次呈现存在很小的差异.
- 在疾病发作之前,prodromal特征通常会加剧,并且在很大程度上是跨诊断的.
- 这些发现支持对情绪和精神疾病的跨诊断预防服务的发展.
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