Background

Psychosis presentation can be affected by genetic and environmental factors. Differentiating between affective and non-affective psychosis (A-FEP and NA-FEP, respectively) may influence treatment decisions and clinical outcomes. The objective of this paper is to examine differences between patients with A-FEP or NA-FEP in a Latin American sample.

Methods

Patients from two cohorts of patients with a FEP recruited from Brazil and Chile. Subjects included were aged between 15 and 30 years, with an A-FEP or NA-FEP (schizophrenia-spectrum disorders) according to DSM-IV-TR. Sociodemographic data, duration of untreated psychosis and psychotic/mood symptoms were assessed. Generalized estimating equation models were used to assess clinical changes between baseline-follow-up according to diagnosis status.

Results

A total of 265 subjects were included. Most of the subjects were male (70.9 %), mean age was 21.36 years. A-FEP and NA-FEP groups were similar in almost all sociodemographic variables, but A-FEP patients had a higher probability of being female. At baseline, the A-FEP group had more manic symptoms and a steeper reduction in manic symptoms scores during the follow- up. The NA-FEP group had more negative symptoms at baseline and a higher improvement during follow-up. All domains of The Positive and Negative Syndrome Scale improved for both groups. No difference for DUP and depression z-scores at baseline and follow-up.

Limitations

The sample was recruited at tertiary hospitals, which may bias the sample towards more severe cases.

Conclusions

This is the largest cohort comparing A-FEP and NA-FEP in Latin America. We found that features in FEP patients could be used to improve diagnosis and support treatment decisions.

中文翻译：

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拉丁美洲早期干预服务中情感性和非情感性精神病的差异

背景

精神病表现可能受遗传和环境因素的影响。区分情感性精神病和非情感性精神病（分别为 A-FEP 和 NA-FEP）可能会影响治疗决策和临床结果。本文的目的是检查拉丁美洲样本中 A-FEP 或 NA-FEP 患者之间的差异。

方法

从巴西和智利招募的两组 FEP 患者的患者。根据 DSM-IV-TR，纳入的受试者年龄在 15 至 30 岁之间，患有 A-FEP 或 NA-FEP（精神分裂症谱系障碍）。评估了社会人口统计学数据、未治疗精神病的持续时间和精神病/情绪症状。广义估计方程模型用于根据诊断状态评估基线随访之间的临床变化。

结果

共纳入 265 名受试者。大多数受试者为男性（70.9%），平均年龄为 21.36 岁。A-FEP 和 NA-FEP 组在几乎所有社会人口学变量中都相似，但 A-FEP 患者的女性概率更高。在基线时，A-FEP 组有更多的躁狂症状，并且在随访期间躁狂症状评分的下降幅度更大。NA-FEP 组在基线时有更多的阴性症状，在随访期间有更高的改善。两组的阳性和阴性症状量表的所有领域都有所改善。基线和随访时 DUP 和抑郁 z 分数没有差异。

限制

样本是在三级医院招募的，这可能会使样本偏向更严重的病例。

结论

这是拉丁美洲比较 A-FEP 和 NA-FEP 的最大队列。我们发现 FEP 患者的特征可用于改善诊断和支持治疗决策。