Validation and refinement of the clinical staging model in a French cohort of outpatient with schizophrenia (FACE-SZ)

被引：14

作者：

Godin, Ophelia ^{[1
,2
]}

Fond, Guillaume ^{[1
,16
,18
]}

Bulzacka, Ewa ^{[1
,15
,18
]}

Schurhoff, Frank ^{[1
,15
]}

Boyer, Laurent ^{[1
,3
]}

Myrtille, Andre ^{[1
,6
]}

Andrianarisoa, Meja ^{[1
,15
,18
]}

Aouizerate, Bruno ^{[1
,4
,13
,17
,19
]}

Berna, Fabrice ^{[1
,5
]}

Capdevielle, Delphine ^{[1
,6
]}

Chereau, Isabelle ^{[1
,7
]}

Dorey, Jean-Michel ^{[1
,8
]}

Dubertret, Caroline ^{[1
,9
]}

Dubreucq, Julien ^{[1
,10
]}

Faget, Catherine ^{[1
,11
]}

Lancon, Christophe ^{[1
,11
]}

Leignier, Sylvain ^{[1
,10
]}

Mallet, Jasmina ^{[1
,9
,11
]}

Misdrahi, David ^{[1
,4
,14
,17
,20
]}

Passerieux, Christine ^{[1
,12
]}

Rey, Romain ^{[1
,8
]}

Roux, Paul ^{[1
,12
]}

Vidailhet, Pierre ^{[1
,5
,12
]}

Costagliola, Dominique ^{[2
]}

Blanc, Olivier ^{[1
,7
]}

Brunel, Lorel ^{[1
,18
]}

Chereau-Boudet, Isabelle ^{[1
,7
]}

Chesnoy-Servanin, Gabrielle ^{[1
,8
]}

Danion, Jean-Marie ^{[1
,5
]}

D'Amato, Thierry ^{[1
,8
]}

Deloge, Arnaud ^{[1
,17
,20
]}

Delorme, Claire ^{[1
,10
]}

Denizot, Helene ^{[1
,7
]}

Doreyh, Jean-Michel ^{[1
,8
]}

Dubertreth, Caroline ^{[1
,9
]}

Fluttaz, Cecile ^{[1
,10
]}

Fonteneau, Sandrine ^{[1
,12
]}

Gabayet, Franck ^{[1
,10
]}

Giraud-Baro, Elisabeth ^{[1
,10
]}

Hardy-Bayle, Marie-Christine ^{[1
,12
]}

Lacelle, Delphine ^{[1
,7
]}

Lanconh, Christophe ^{[1
,11
]}

Laouamri, Hakim ^{[1
]}

Leboyer, Marion ^{[1
,15
,18
]}

Le Gloahec, Tifenn ^{[1
,18
]}

Le Strat, Yann ^{[1
,9
]}

Llorcap, Pierre-Michel ^{[1
,7
]}

Metairie, Emeline ^{[1
,11
]}

Peri, Pauline ^{[1
,11
]}

Pires, Sylvie ^{[1
,7
]}

机构：

[1] Fdn FondaMental, Creteil, France

[2] UPMC Univ Paris 06, Sorbonne Univ, UMR S 1136, Inst Pierre Louis Epidemiol & Sante Publ,INSERM, F-75013 Paris, France

[3] CHU St Marguerite, Pole Psychiat Univ, F-13274 Marseille 09, France

[4] Univ Bordeaux, Ctr Hosp Charles Perrens, F-33076 Bordeaux, France

[5] Univ Strasbourg, Hop Univ Strasbourg, INSERM U1114, Federat Med Translat Strasbourg, Strasbourg, France

[6] Univ Montpellier I, CHRU Montpellier, Hop Colombiere, Serv Univ Psychiat Adulte,Inserm 1061, Montpellier, France

[7] Univ Auvergne, CHU, CMP B, BP 69, F-63003 Clermont Ferrand 1, France

[8] Univ Claude Bernard Lyon 1, CNRS UMR5292, INSERM U1028, Ctr Rech Neurosci Lyon,Equipe PSYR2,Ctr Hosp Vina, 95 Bd Pinel,BP 30039, F-69678 Bron, France

[9] Univ Paris Diderot, Sorbonne Paris Cite, Louis Mourier Hosp, AP HP,INSERM U894,Dept Psychiat,Fac Med, Paris, France

[10] CH Alpes Isere, Ctr Referent Rehabil Psychosociale, Grenoble, France

[11] AP HM, Pole Univ Psychiat, Marseille, France

[12] Univ Versailles St Quentin En Yvelines, UFR Sci Sante Simone Veil, Ctr Hosp Versailles, Serv Univ Psychiat Adultes, Versailles, France

[13] UMR INRA 1286, Lab Nutr & Neurobiol Integree, F-33076 Bordeaux, France

[14] INCIA, CNRS UMR 5287, Bordeaux, France

[15] Univ Paris Est Creteil, Hop Univ H Mondor, AP HP,INSERM U955,Pole Psychiat, DHU Pe PSY,Mondor Inst Biomed Res,Translat Psychi, Creteil, France

[16] Aix Marseille Univ, AP HM, Fac Med, Sect Timone,EA 3279 CEReSS, F-13005 Marseille, France

[17] Ctr Hosp Charles Perrens, F-33076 Bordeaux, France

[18] Univ Paris Est Creteil, Hop Univ H Mondor, AP HP,INSERM U955,DHU Pe PSY, Eq 15 Psychiat Translat,Pole Psychiat & Addictol, Creteil, France

[19] Univ Bordeaux, INSERM, Neuroctr Magendie Physiopathol Plasticite Neurona, U862, F-33000 Bordeaux, France

[20] Univ Bordeaux, CNRS UMR 5287, INCIA, Bordeaux, France

来源：

PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY | 2019年 / 92卷

关键词：

Clinical staging; Schizophrenia; Prognosis; Cognition; Comorbidity; 2ND-GENERATION ANTIPSYCHOTICS; NEGATIVE SYMPTOMS; CHILDHOOD TRAUMA; LANGUAGE VERSION; RATING-SCALE; DEPRESSION; ADHERENCE; VALIDITY; 1ST;

D O I：

10.1016/j.pnpbp.2019.01.003

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: Existing staging models have not been fully validated. Thus, after classifying patients with schizophrenia according to the staging model proposed by McGorry et al. (2010), we explored the validity of this staging model and its stability after one-year of follow-up. Method: Using unsupervised machine-learning algorithm, we classified 770 outpatients into 5 clinical stages, the highest being the most severe. Analyses of (co) variance were performed to compare each stage in regard to socio-demographics factors, clinical characteristics, co-morbidities, ongoing treatment and neuropsychological profiles. Results: The precision of clinical staging can be improved by sub-dividing intermediate stages (II and III). Clinical validators of class IV include the presence of concomitant major depressive episode (42.6% in stage IV versus 3.4% in stage IIa), more severe cognitive profile, lower adherence to medication and prescription of > 3 psychotropic medications. Follow-up at one-year showed good stability of each stage. Conclusion: Clinical staging in schizophrenia could be improved by adding clinical elements such as mood symptoms and cognition to severity, relapses and global functioning. In terms of therapeutic strategies, attention needs to be paid on the factors associated with the more stages of schizophrenia such as treatment of comorbid depression, reduction of the number of concomitant psychotropic medications, improvement of treatment adherence, and prescription of cognitive remediation.

引用

页码：226 / 234

页数：9

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