Original article

Korean Journal of Schizophrenia Research 2009;12(1):33-41.

정신병 고위험 대상자의 임상적 특징

Mu-Sung Lim2, Young-Chul Chung1,2, Ya-Young Park1 and Guang-Biao Huang1

Abstract

Objectives:We investigated help-seeking behavior and clinical characteristics of subjects at high risk for psychosis. Also, naturalistic observation of medication prescribing patterns was conducted.
Methods:Using comprehensive assessment of at risk mental states (CAARMS) criteria, 21 subjects at high risk for psychosis were enrolled. Spontaneous help seeking behavior, key helpers recommended psychiatric evaluation and duration of untreated attenuated symptoms (DUAPS) were investigated. As for clinical characteristics, Positive and Negative Syndrome Scale (PANSS), Scale for the Assesment of Negative Symptoms (SANS), Hamilton Rating Scale For Depression (HRSD), Hamilton Rating Scale For Anxiety (HRSA), Global Assessment of Functioning (GAF), Clinical Global Impressions-severity (CGI-S), Korean Insight Scale for Psychosis (KISP), Korean version of Beck Cognitive Insight Scale (BCIS-K), and Premorbid Adjustment Scale (PAS) were used. Type and dose of medication were also investigated.
Results:Spontaneous help-seeking behavior was observed only in 33% of the subjects. DUAPS was substantial. The key person to whom help seeking behavior was most frequently sought out and who helped the subjects to visit psychiatric service was family members. The most common subtype of the subject at high risk for psychosis by CAARMS criteria was attenuated psychosis group. The DSM-IV diagnoses were psychotic disorder NOS, adjustment disorder, anxiety disorder NOS, etc. The subjects were found to have significant depression and anxiety with impairment of global functioning, premorbid adjustment and insight. Antipsychotic drugs were prescribed more frequently than antidepressants.
Conclusion:This study illustrates that the subjects at high risk for psychosis suffer from substantial level of depression and anxiety in addition to attenuated psychotic symptoms with low level of help seeking behavior. To these individuals, antipsychotics were preferred compared to antidepressants. (Korean J Schizophr Res 2009;12:33-41)

Key Words: Comprehensive assessment of at risk mental states,Help seeking behaviorㆍHigh-risk for psychosisㆍ InsightㆍPremorbid adjustmentㆍSchizophrenia.