Psychosis risk syndrome is not prodromal psychosis

Shanghai Arch Psychiatry. 2015 Feb 25;27(1):42-4. doi: 10.11919/j.issn.1002-0829.214178.

Abstract

One of the most exciting trends in schizophrenia research is the shift in focus from treatment studies to studies about the early identification and prevention of schizophrenia. These studies have primarily focused on adolescents or young adults with prodromal symptoms or on clinically high-risk individuals who show similar impairments in cognitive and social functioning to those seen in individuals with schizophrenia and, thus, are considered at high risk of developing schizophrenia or other psychotic disorders. Some researchers have labeled this condition as psychosis risk syndrome (PRS). There are moves in some circles to re-define the condition as a disorder in its own right: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 5(th) edition (DSM-5), lists 'attenuated psychosis syndrome' (APS) in the appendix as a condition for further study. Individuals with PRS are certainly at higher risk of developing a psychotic disorder than those without PRS, but the majority of those with PRS do not subsequently develop a psychotic disorder, so we argue against the inclusion of PRS or APS as a subtype of schizophrenia spectrum disorder.

概述: 精神分裂症研究中最令人振奋的趋势之一是从治疗学研究转向精神分裂症的早期识别和早期干预研究。后者的研究对象主要集中于处于精神病“前驱期”或“临床高危”的青少年或年轻的成年患者,他们出现的认知功能障碍和社会功能障碍与精神分裂症患者相似,因而被认为具有精神分裂症或其他精神病性障碍的高患病风险。有学者将这种认知和社会功能障碍的表现称为精神病风险综合征(psychosis risk syndrome, PRS)。在某些范围内已有试图将这一状态重新定义为一种精神障碍的举动,如:美国精神医学学会的《精神障碍诊断与统计手册》第五版(DSM-5)将“轻微精神病综合征”(attenuated psychosis syndrome, APS)列入“需要进一步研究的状态”。存在PRS的个体出现精神病性障碍的风险的确比没有PRS的人要高,但多数PRS个体以后也不会患精神病性障碍,因此,我们反对将PRS或APS作为一种亚型列入精神分裂症谱系障碍中。.

中文全文: 本文全文中文版从2015年4月8日起在http://dx.doi.org/10.11919/j.issn.1002-0829.214178可供免费阅览下载.

Keywords: attenuated psychosis syndrome; psychosis risk syndrome; schizophrenia spectrum disorder.

Grants and funding

The preparation of this forum was supported by National Natural Science Foundation of China (81201043, 81171267, 61102020, 81261120410, 81361120403), Shanghai Municipal Natural Science Foundation (12ZR1448400), National Key Clinical Disciplines at Shanghai Mental Health Center (Office of Medical Affairs, Ministry of Health, 2011-873; OMA-MH, 2011-873).