Ocena niezależnych czynników ryzyka konwersji w psychozę w grupie osób z wysokim ryzykiem rozwoju zaburzeń psychotycznych

Gawłowska, Marta; Rabe-Jabłońska, Jolanta; Pawełczyk, Tomasz; Pawełczyk, Agnieszka

Journal

Psychiatria i Psychologia Kliniczna

2010 | 10 | 4 | 254-266

Article title

Ocena niezależnych czynników ryzyka konwersji w psychozę w grupie osób z wysokim ryzykiem rozwoju zaburzeń psychotycznych

Authors

Marta Gawłowska , Jolanta Rabe-Jabłońska , Tomasz Pawełczyk , Agnieszka Pawełczyk

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ocena-niezaleznych-czynnikow-ryzyka-konwersji-w-psychoze-w-grupie-osob-z-wysokim-ryzykiem-rozwoju-zaburzen-psychotycznych.pdf

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Title variants

Assessment of independent risk factors of conversion into psychosis in the ultra-high risk state group of patients

Languages of publication

EN PL

Abstracts

Background: The aim of this study was the independent psychosis risk factors assessment in a group of subjects fulfilling the criteria of at risk mental state, under specialist outpatient psychiatric care. Participants: Seventy-one patients – 33 women and 38 men, were involved into this study, aged on average 17.34, all under psychiatric care. The patients were recruited into the study in the sequence of their outpatient clinic admission. The criterion to be included into the study was the diagnosis of ultra-high risk state (UHRS) – defined according to the Australian research group principles. Subsequently, the patients were divided into subgroups according to the clinical features of their mental state. Method: The author’s demographic questionnaire was applied in the study. Information regarding the family history of psychosis was obtained from patients and/or their relatives or carers. The patients’ mental state was assessed monthly – according to the presence of psychotic symptoms, change of their incidence and duration, presence of depressive symptoms or aggressive behaviour (measured by a three-level scale). On the basis of the obtained information, we evaluated: 1) conversion into psychosis time – measured from diagnosing of UHRS to the development of full-symptom psychosis, 2) therapeutic methods used (psychotherapy, pharmacotherapy or both), 3) use of psychoactive substances after being diagnosed with UHRS, 4) presence of serious life stressors (the patients’ subjective estimation) – during the six-month period preceding the conversion into psychosis. Results: 1) In the UHRS group of patients, staying under professional outpatient psychiatric care, the use of marijuana was an independent risk factor of conversion into psychosis. 2) In the investigated group of patients with at risk mental state we did not find any correlation between modulating factors (including: therapeutic methods used, depressive symptoms, aggression or clinical features of UHRS patients’ subgroups or duration of staying under professional psychiatric care) and controlled period without conversion into psychosis.

Założenia i cel pracy: Celem pracy było poszukiwanie niezależnych czynników ryzyka konwersji w psychozę w grupie osób spełniających kryteria ryzykownego stanu psychicznego i pozostających pod ambulatoryjną opieką lekarską. Grupa badana: Do udziału w badaniu zakwalifikowano 71 pacjentów – 33 kobiety i 38 mężczyzn, ze średnią wieku 17,34 roku, pozostających w opiece ambulatoryjnej. Pacjenci byli kolejno włączani do badania w porządku odpowiadającym chronologii zgłaszania się do poradni. Kryterium włączenia do badania było stwierdzenie obecności stanu ryzyka rozwoju psychozy (ultra-high risk state, UHRS), definiowanego według zasad zaproponowanych przez zespół australijskich badaczy. Pacjenci byli następnie kwalifikowani do jednej z podgrup UHRS – w zależności od obserwowanego obrazu klinicznego. Metoda: W badaniu wykorzystano autorski kwestionariusz do zbierania danych demograficznych. Dane o obciążeniu rodzinnym psychozą uzyskano na podstawie wywiadu z pacjentem i/lub jego opiekunami. Od momentu włączenia uczestników do grupy UHRS co miesiąc oceniano ich stan psychiczny pod kątem wystąpienia objawów psychotycznych, zmiany czasu ich trwania i częstości występowania, obecności objawów depresyjnych i agresji (nasilenie oceniano w trójstopniowej skali). Na podstawie uzyskanej dokumentacji ustalono: 1) czas przejścia w psychozę – obliczany od momentu stwierdzenia UHRS do momentu wystąpienia objawów pełnej psychozy (z dokładnością do 1 miesiąca), 2) stosowane metody terapeutyczne (psychoterapia, farmakoterapia, obie formy), 3) używanie substancji psychoaktywnych po stwierdzeniu UHRS, 4) występowanie poważnych sytuacji stresujących (wg subiektywnej oceny badanych) w ostatnim półroczu przed konwersją w psychozę. Wnioski: 1) Stwierdzono, że w grupie badanych spełniających kryteria stanu wysokiego ryzyka rozwoju psychozy (UHRS) i pozostających pod ambulatoryjną opieką lekarską używanie marihuany było niezależnym czynnikiem ryzyka konwersji w psychozę. 2) W badanej populacji pacjentów z grupy ryzyka rozwoju psychozy nie wykazano istotnego związku pomiędzy zastosowanymi czynnikami modulującymi (w tym: stosowanymi procedurami terapeutycznymi, nasileniem objawów depresyjnych, agresji oraz obrazem klinicznym definiowanym zgodnie z kryteriami wyróżniania podgrup UHRS) z czasem pozostawania w opiece psychiatrycznej bez konwersji w psychozę.

Keywords

czynniki
modulujące czynniki ryzyka konwersji w psychozę marihuana modulating factors psychosis psychoza risk factors of conversion into psychosis stan wysokiego ryzyka rozwoju psychozy ultra-high risk state

Discipline

MEDICINE: MEDICINE

Publisher

Journal

Psychiatria i Psychologia Kliniczna

Year

2010

Volume

Issue

Pages

254-266

Physical description

Contributors

author

Marta Gawłowska

Klinika Zaburzeń Afektywnych i Psychotycznych, Katedra Psychiatrii Uniwersytetu Medycznego w Łodzi. Kierownik: prof. dr hab. n. med. Jolanta Rabe-Jabłońska

author

Jolanta Rabe-Jabłońska

vKlinika Zaburzeń Afektywnych i Psychotycznych, Katedra Psychiatrii Uniwersytetu Medycznego w Łodzi. Kierownik: prof. dr hab. n. med. Jolanta Rabe-Jabłońska

author

Tomasz Pawełczyk

Klinika Zaburzeń Afektywnych i Psychotycznych, Katedra Psychiatrii Uniwersytetu Medycznego w Łodzi. Kierownik: prof. dr hab. n. med. Jolanta Rabe-Jabłońska

author

Agnieszka Pawełczyk

Klinika Zaburzeń Afektywnych i Psychotycznych, Katedra Psychiatrii Uniwersytetu Medycznego w Łodzi. Kierownik: prof. dr hab. n. med. Jolanta Rabe-Jabłońska

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article

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bwmeta1.element.psjd-81ed988d-bd39-48d8-a561-3d82ded8b438