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La relación entre factores predisponentes, función premórbida y dimensiones de síntomas en la psicosis: un enfoque integrado

Published online by Cambridge University Press:  12 May 2020

Almudena Guerra ,
Paul Fearon ,
Pak Sham ,
Peter Jones ,
Shon Lewis ,
Ignacio Mata  and
Robin Murray
Almudena Guerra
Affiliation:
Gerencia Torribera, Santa Coloma de Gamanera, Barcelona, España
Paul Fearon
Affiliation:
Instituto de Psiquiatría, Londres, Reino Unido
Pak Sham
Affiliation:
Instituto de Psiquiatría, Londres, Reino Unido
Peter Jones
Affiliation:
Departamento de Psiquiatría, Universidad de Cambridge, Reino Unido
Shon Lewis
Affiliation:
MRCPsych, Departamento Universitario de Psiquiatría, Hospital Withington, Manchester, Reino Unido
Ignacio Mata
Affiliation:
Hospital Virgen del Camino, Pamplona, España
Robin Murray
Affiliation:
Instituto de Psiquiatría, Londres, Reino Unido
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Resumen

Antecedentes:

Cada vez más datos indican que la psicosis se puede enfocar más significativamente desde un punto de vista dimensional que como estados cualitativos discretos, y que se pueden identificar grupos de síntomas específicos. Si es así, factores de riesgo particulares y factores premórbidos pueden predecir estos grupos de síntomas.

Propósitos:

(I) Explorar, utilizando el análisis de componentes principales, si se pueden aislar factores específicos para los síntomas psicóticos. (II) Establecer los predictores de los diferentes factores de síntomas utilizando técnicas de regresión múltiple.

Método:

Se seleccionó a 189 pacientes hospitalizados con enfermedad psicótica y se obtuvo de ellos y de sus madres información sobre los antecedentes familiares, los factores premórbidos y los síntomas actuales.

Resultados:

Se identificaron siete componentes de síntomas distintos. El análisis de regresión no identificó ningún predictor evolutivo de la depresión o la manía. Los antecedentes familiares de esquizofrenia y el mal funcionamiento escolar a pesar de un CI premórbido normal predecían las ideas delirantes/alucinaciones (F = 6,5; P < 0,001); el comienzo temprano de la enfermedad, el retraso evolutivo y los antecedentes familiares de psicosis predecían los síntomas negativos (F = 4,1; P = 0,04). De modo interesante, la combinación de antecedentes familiares de trastorno bipolar y CI premórbido bajo predecía la desorganización (F = 4,9; P < 0,003), y las complicaciones obstétricas (CO) y el mal funcionamiento escolar predecían la paranoia (F = 4,2; P < 0,01).

Conclusión:

Las ideas delirantes y las alucinaciones, los síntomas negativos y la paranoia parecían tener un origen evolutivo, aunque se asociaban con problemas infantiles diferentes. Por otra parte, ni la manía ni la depresión se asociaban con disfunción en la infancia. Nuestro hallazgo más sorprendente fue que la desorganización parecía surgir cuando una predisposición familiar a la manía se combinaba con CI premórbido bajo.

Keywords

dimensiónfactorintegradopremórbidopsicosissíntoma
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 10 , Issue 2 , March 2003 , pp. 81 - 91
Copyright
Copyright © European Psychiatric Association 2003

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