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

Objective: 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 st...

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Detalles Bibliográficos
Autores: Verdolini, Norma, Borràs, Roger, Sparacino, Giulio, Garriga, Marina, Sagué Vilavella, Maria, Madero Gómez, Santiago, Palacios Garrán, Roberto, Serra Navarro, Maria, Forte, Maria Florencia, Salagre Muñoz, Estela, Aedo, Alberto, Salgado Pineda, Pilar, Montoro Salvatierra, Irene, Sánchez Gistau, Vanessa, Pomarol-Clotet, Edith, Ramos Quiroga, Josep Antoni, Carvalho, André F., García Rizo, Clemente, Undurraga Fourcade, Juan Pablo, Reinares, María, Martinez Aran, Anabel, Bernardo Arroyo, Miquel, Vieta i Pascual, Eduard, 1963-, Pacchiarotti, Isabella, Amoretti Guadall, Silvia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/190776
Acceso en línea:https://hdl.handle.net/2445/190776
Access Level:acceso abierto
Palabra clave:Psicosi
Trastorn bipolar
Factors de risc en les malalties
Psicosi en els adolescents
Adults
Símptomes
Psychoses
Manic-depressive illness
Risk factors in diseases
Psychoses in adolescence
Adulthood
Symptoms
Descripción
Sumario:Objective: 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. Methods: 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. Results: 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. Conclusion: Early characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.

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