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Title: 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
Author: Verdolini, Norma
Borràs, Roger
Sparacino, Giulio
Garriga, Marina
Sagué Vilavella, Maria
Madero, Santiago
Palacios Garrán, Roberto
Serra, Maria
Forte, Maria Florencia
Salagre, 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
Keywords: Psicosi
Trastorn bipolar
Factors de risc en les malalties
Psicosi en els adolescents
Manic-depressive illness
Risk factors in diseases
Psychoses in adolescence
Issue Date: 25-Feb-2022
Publisher: John Wiley & Sons
Abstract: 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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It is part of: Acta Psychiatrica Scandinavica, 2022, vol. 146, num. 1, p. 36-50
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ISSN: 0001-690X
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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