标题： 妄想和幻觉在早期精神病各阶段的出现和动态变化 显示英文标题

标题： Emergence and dynamics of delusions and hallucinations across stages in early psychosis

摘要： 幻觉和妄想通常被归为精神病的阳性症状。 然而，最近的证据表明它们可能由不同的计算和神经机制驱动。 研究它们出现的时间过程可能有助于了解这些潜在机制之间的关系。 来自北美前驱期纵向研究（NAPLS 2和3）第二（N = 719）和第三（N = 699）轮次的参与者被评估了CHR-P水平妄想和幻觉的出现时间。 还评估了来自精神分裂症早期干预预防计划（PEPP-Montreal；N = 694）的第一次发作精神分裂症患者（FEP）在发病前的症状模式。 症状出现时间是在基线评估时确定的，并在24个月内检查了症状模式的变化。 在所有三个样本中，参与者更有可能报告妄想谱症状的出现早于幻觉谱症状（比值比（OR）：NAPLS 2 = 4.09；NAPLS 3 = 4.14；PEPP，Z = 7.01，P < 0.001），并且与仅出现幻觉相比，更可能出现仅妄想（OR：NAPLS 2 = 5.6；NAPLS 3 = 11.11；PEPP = 42.75）。 在缓解后妄想再次出现的情况也比幻觉再次出现更常见（Ps < 0.05），且幻觉更常首先消失（Ps < 0.001）。 在两个CHR-P样本中，妄想观念的评分在幻觉出现时下降（P = 0.007）。 妄想往往出现在幻觉之前，并可能在其发展中发挥作用。 进一步的工作应研究这些症状驱动机制之间的关系及其在诊断和治疗中的应用价值。 显示英文摘要

摘要： Hallucinations and delusions are often grouped together within the positive symptoms of psychosis. However, recent evidence suggests they may be driven by distinct computational and neural mechanisms. Examining the time course of their emergence may provide insights into the relationship between these underlying mechanisms. Participants from the second (N = 719) and third (N = 699) iterations of the North American Prodrome Longitudinal Study (NAPLS 2 and 3) were assessed for timing of CHR-P-level delusion and hallucination onset. Pre-onset symptom patterns in first-episode psychosis patients (FEP) from the Prevention and Early Intervention Program for Psychosis (PEPP-Montreal; N = 694) were also assessed. Symptom onset was determined at baseline assessment and the evolution of symptom patterns examined over 24 months. In all three samples, participants were more likely to report the onset of delusion-spectrum symptoms prior to hallucination-spectrum symptoms (odds ratios (OR): NAPLS 2 = 4.09; NAPLS 3 = 4.14; PEPP, Z = 7.01, P < 0.001) and to present with only delusions compared to only hallucinations (OR: NAPLS 2 = 5.6; NAPLS 3 = 11.11; PEPP = 42.75). Re-emergence of delusions after remission was also more common than re-emergence of hallucinations (Ps < 0.05), and hallucinations more often resolved first (Ps < 0.001). In both CHR-P samples, ratings of delusional ideation fell with the onset of hallucinations (P = 0.007). Delusions tend to emerge before hallucinations and may play a role in their development. Further work should examine the relationship between the mechanisms driving these symptoms and its utility for diagnosis and treatment.