目的 探讨精神病高危综合征人群临床转归与其心理理论(theory of mind,To M)特征的关系。方法 利用前驱期综合症结构式访谈(structured interview for psychosis-risk syndromes,SIPS)和前驱期综合症量表(scale of psychosis-risk symptoms,SOPS)筛选出精神病高危综合征(clinical high risk,CHR)者90例,用失言觉察任务(faux pas test,FPT)、眼神阅读测试(reading the mind in the eyes text,RMET)评估CHR者心理理论特征。进行为期2年随访,利用SIPS确定临床转归,根据精神病转归情况将CHR者分为转化组(20例)和未转化组(50例),对两组基线水平临床症状特征、FPT、RMET结果进行分析,比较其心理理论的差异。结果 两组CHR者在基线水平临床症状差异无统计学意义(P〉0.05);在FPT中,两组CHR失言故事识别得分、失言故事理解得分和失言任务总分存在统计学差异(P〈0.05),在对照故事识别得分上无统计学差异(P〉0.05);两组RMET各结果无统计学差异(P〉0.05)。结论 精神病高危人群心理理论能力受损严重个体精神病转化的风险更高。
Objective To explore the clinical outcome of individuals with Clinical High Risk (CHR) for psy- chosis and its relationship with Theory of Mind (TOM) function. Methods The Structured Interview for Prodromal Symptoms/Scale of Prodromal Syndromes (SIPS/SOPS) was applied to assess prodromal psychosis. The Reading the mind in the Eyes and faux pas Task were conducted to assess the function of Theory of Mind among the individuals of clinical high risk of psychosis. All participants had completed the 2-year follow-up. Conversion was determined using the criteria of presence of psychotic symptoms (POPS). According to the outcome, CHR individuals were divided into conversion group (n=20) and no-conversion group (n=50). The baseline clinical symptom characteristics and Theory of Mind were compared between groups. Results There was no significant difference in clinical symptom characteristics among individuals with CHR (P〉O.05). In the faux pas text, there were significant differences in Faux Pas Detection (P=0.01), Faux Pas Understanding (P=0.01) and Faux Pas Total (P=0.02) but not in control stories and the Reading the Mind in the Eyes Test between convertors and non-convertors (P〉0.05). Conclusion The ToM disability in clini- cal high risk population increases risk for conversion to psychosis.