Verdolini N, Borràs R, Sparacino G, Garriga M, Sagué‐Vilavella M, Madero S, Palacios‐Garrán R, Serra M, Forte MF, Salagre E, Aedo A, Salgado‐Pineda P, Salvatierra IM, Sánchez Gistau V, Pomarol‐Clotet E, Ramos‐Quiroga JA, Carvalho AF, Garcia‐Rizo C, Undurraga J, Reinares M, Martinez Aran A, Bernardo M, Vieta E, Pacchiarotti I, Amoretti S. 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.
Acta Psychiatr Scand 2022;
146:36-50. [PMID:
35170748 PMCID:
PMC9305219 DOI:
10.1111/acps.13415]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/29/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
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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