从急性和短暂的精神病转变为精神分裂症的诊断转变的综合预测因素:一项回顾性研究
Yanyan Lu1, Qiang Wang2, Xuzhen Liu1
1Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, People's Republic of China.
Neuropsychiatric disease and treatment
|November 1, 2024
概括
这项研究开发了一种预测模型,以识别可能转变为精神分裂症 (SCZ) 的急性和过渡性精神病障碍 (ATPD) 患者. 关键预测因素包括治疗后单细胞计数和MLR,有助于精神病的早期干预.
科学领域:
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
- 医学统计 医学统计
背景情况:
- 急性和过渡性精神病障碍 (ATPD) 可以演变为慢性疾病,如精神分裂症 (SCZ).
- 准确预测SCZ从ATPD过渡的情况对于及时干预至关重要.
- 确定ATPD患者SCZ发展的预测因素是临床优先事项.
研究的目的:
- 利用临床数据开发一个预测模型,预测从ATPD过渡到SCZ.
- 确定ATPD患者中SCZ发展的显著临床和炎症预测因素.
- 评估SCZ过渡所识别的因素的预测性能.
主要方法:
- 利用考克斯比例风险回归对396名被诊断为ATPD的住院患者 (ICD-10标准) 的临床数据.
- 分析了人口统计数据,临床特征和炎症标记 (单细胞计数,MLR) 作为潜在的预测因素.
- 采用时间依赖的接收器运行特征 (TimeROC) 分析来评估预测准确性.
主要成果:
- 43.69%的ATPD患者在随访期间过渡到SCZ.
- 治疗后单细胞计数,单细胞/淋巴细胞比率 (MLR) 和精神分裂症症状是显著的预测因素.
- 综合预测因素在5年随访后达到0.728的AUC,MLR显示出强大的预测能力 (AUC=0.764).
结论:
- 综合临床和炎症标志物的预测模型显示出预测SCZ从ATPD过渡的良好能力.
- 治疗后的MLR是SCZ的诊断修订的强有力的预测器.
- 这些发现支持使用特定的生物标志物和临床特征用于ATPD患者早期风险分层.
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