Prodromal phase : Differences in prodromal symptoms, risk factors and markers of vulnerability in first episode mania versus first episode psychosis with onset in late adolescence or adulthood
Verdolini, Norma (Hospital Clínic i Provincial de Barcelona)
Borràs, Roger (Hospital Clínic i Provincial de Barcelona)
Sparacino, Giulio (Hospital Clínic i Provincial de Barcelona)
Garriga, Marina (Hospital Clínic i Provincial de Barcelona)
Sagué-Vilavella, Maria (Hospital Clínic i Provincial de Barcelona)
Madero, Santiago (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Palacios-Garrán, Roberto (Hospital Clínic i Provincial de Barcelona)
Serra, Maria (Hospital Clínic i Provincial de Barcelona)
Forte, Maria Florencia (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Salagre, Estela (Hospital Clínic i Provincial de Barcelona)
Aedo, Alberto (Hospital Clínic i Provincial de Barcelona)
Salgado-Pineda, Pilar (FIDMAG Germanes Hospitalàries Research Foundation)
Salvatierra, Irene Montoro (Universitat Rovira i Virgili)
Sánchez Gistau, Vanessa (Universitat Rovira i Virgili)
Pomarol-Clotet, Edith (FIDMAG Germanes Hospitalàries Research Foundation)
Ramos-Quiroga, Josep Antoni (Hospital Universitari Vall d'Hebron)
Carvalho, André F (Deakin University)
Garcia Rizo, Clemente (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Undurraga, Juan (Instituto Psiquiátrico Dr. J. Horwitz Barak)
Reinares, María (Hospital Clínic i Provincial de Barcelona)
Martínez-Àran, Anabel (Hospital Clínic i Provincial de Barcelona)
Bernardo, Miquel (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Vieta, Eduard (Hospital Clínic i Provincial de Barcelona)
Pacchiarotti, Isabella (Hospital Clínic i Provincial de Barcelona)
Amoretti, Silvia (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	This study was aimed at identifying differences in the prodromal symptoms and their duration, risk factors and markers of vulnerability in patients presenting a first episode mania (FEM) or psychosis (FEP) with onset in late adolescence or adulthood in order to guide tailored treatment strategies. Patients with a FEM or FEP underwent a clinical assessment. Prodromes were evaluated with the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R). Chi-squared tests were conducted to assess specific prodromal symptoms, risk factors or markers of vulnerability between groups. Significant prodromal symptoms were entered in a stepwise forward logistic regression model. The probabilities of a gradual versus rapid onset pattern of the prodromes were computed with logistic regression models. The total sample included 108 patients (FEM = 72, FEP = 36). Social isolation was associated with the prodromal stage of a FEP whilst Increased energy or goal - directed activity with the prodrome to a FEM. Physically slowed down presented the most gradual onset whilst Increased energy presented the most rapid. The presence of obstetric complications and difficulties in writing and reading during childhood were risk factors for FEP. As for markers of vulnerability, impairment in premorbid adjustment was characteristic of FEP patients. No specific risk factor or marker of vulnerability was identified for FEM. Early characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.
Ayudas:	Ministerio de Economía y Competitividad CPII16/00018 Ministerio de Economía y Competitividad PI15/00283 Instituto de Salud Carlos III PI18/00805 Instituto de Salud Carlos III PI18/01001
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	First episode mania ; First episode psychosis ; Markers of vulnerability ; Prodromes ; Risk factors
Publicado en:	Acta psychiatrica Scandinavica, Vol. 146 (february 2022) , p. 36-50, ISSN 1600-0447

DOI: 10.1111/acps.13415
PMID: 35170748

15 p, 471.4 KB

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