摘要：
Objective To investigate the clinical features of psychopathology symptoms and function in individuals with attenuated psychosis syndrome (APS) in China.Method Seventy-six individuals with APS were identified using the Structured Interview for Psychosis-Risk Syndromes (SIPS) from 7 research centers.Sixty-two controls in communities were recruited.Participants were administered measures of psychosis risk symptoms Scale of Psychosis-Risk Symptoms (SOPS),depressive symptoms Montgomery-(A)sberg Depression Rating Scale (MADRS) and function status Global Assessment of Functioning (GAF).The above clinical characteristics were compared between the two groups,and the correlation between these features were also explored.Results Compared with health controls,the APS subjects had higher scores of SOPS (26.25 ± 11.73 vs.1.48 ± 1.66) and it's subscales of (positive symptoms (8.75 ± 3.69 vs.0.31 ±0.56),negative symptoms (8.06 ±6.15 vs.0.33 ±0.59),disorganized symptoms (3.67 ±2.84 vs.0.36 ±0.66),and general symptoms (5.76 ±3.40 vs.0.48 ±0.67)),and MADRS (12.42 ±9.39 vs.0.39 ± 0.98),and a lower score of GAF (62.28 ±13.25 vs.88.61±4.74;Z=10.08,10.29,9.19,8.10,8.93,9.69,9.94,all P ＜ 0.01).In the individuals with APS,the most common psychosis risk symptoms were unusual thought content (68.4％,52/76),suspiciousness/persecutory ideas (56.6％,43/76) and dysphoric mood (48.7％,37/76).There were 51.3％ (39/76) subjects with APS having concurrent depressive symptoms,which were significantly related with negative symptoms (r =0.444,P ＜ 0.0l) and general symptoms(r =0.571,P ＜ 0.01).The GAF significantly negatively correlated with all the psychosis risk symptoms(r =-0.377--0.700,P ＜ 0.01) and the depressive symptom (r =-0.370,P ＜ 0.01).Moreover,a higher score of the positive symptom (t =-3.19,P =0.002) or the negative symptom (t =-3.81,P ＜ 0.01) could significantly predicted a lower score of GAF.Conclusions The positive risk symptoms,negative risk symptoms and the social function impairment may be the core clinical symptoms of APS,and the nonspecific risk symptoms and the concurrent depressive symptoms are common as well.%目的 调查轻微精神病综合征(attenuated psychosis syndrome,APS)患者的精神病理学症状和社会功能特征.方法 在全国7家研究中心筛选入组76例APS患者(APS组),同期在社区招募62名健康对照者(对照组).采用精神病风险症状量表(Scale of Psychosis-Risk Symptoms,SOPS)、蒙哥马利-艾森伯格抑郁量表(Montgomery-(A)sberg Depression Rating Scale,MADRS)和功能整体评定量表(Global Assessment of Functioning,GAF)评估APS患者的精神病风险症状、抑郁症状和社会功能,并与对照组进行比较,探讨临床特征及相互关系.结果 APS组与对照组相比,SOPS总分[(26.25 ±11.73)分与(1.48±1.66)分]和分量表评分[阳性症状:(8.75±3.69)分与(0.31±0.56)分,阴性症状:(8.06±6.15)分与(0.33±0.59)分,瓦解症状:(3.67±2.84)分与(0.36±0.66)分,一般症状:(5.76±3.40)分与(0.48±0.67)分],以及MADRS评分[(12.42 ±9.39)分与(0.39±0.98)分]和GAF评分[(62.28±13.25)分与(88.61±4.74)分]之间的差异均有统计学意义(Z=10.08、10.29、9.19、8.10、8.93、9.69、9.94,均P＜0.01).APS最常见的精神病风险症状是思维内容异常(68.4％,52/76)、猜疑被害观念(56.6％,43/76)和心境烦躁(48.7％,37/76).51.3％ (39/76)的APS患者伴发抑郁症状,并与阴性症状(r=0.444)和一般症状(r=0.571)呈正相关(均P＜0.01).GAF与精神病风险症状(r=-0.377～-0.700)和抑郁症状(r=-0.370)呈负相关(均P＜0.01).多元线性回归分析显示,阳性风险症状(t=-3.19,P=0.002)和阴性风险症状(t=-3.81,P＜0.01)对GAF的预测作用具有统计学意义.结论 阳性风险症状、阴性风险症状和社会功能损害是APS的3个主要核心症状,抑郁症状和其他非特异性症状也较常见.
