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目的 调查轻微精神病综合征(attenuated psychosis syndrome,APS)患者风险症状的临床结局,探索影响结局的相关因素.方法 在7家研究中心筛选入组63例APS患者.使用精神病风险症状量表评估APS患者基线和6个月时的精神病理学特征,分析精神病风险症状的临床结局及相关因素.结果 共47例APS患者完成随访,完成随访者(n=47)和失访者(n=16)间除年龄差异具有统计学意义(F=5.23,P＜0.05),其他社会人口学资料(x2=2.30～3.28)和精神病风险症状(F=0.01～2.10)差异均无统计学意义(均P＞0.05).APS在6个月内的转化率为17.0％(8/47),维持率为38.3％(18/47),恢复率为44.7％(21/47).3种结局状态的APS患者在基线时的人口学资料(x2=0.39～15.10)和社会功能(F=0.71)的差异均无统计学意义(均P＞0.05),阳性症状[(9.3±2.8)、(8.8±2.5)、(6.6±3.4)分,F=3.39]、瓦解症状[(5.5±2.2)、(3.8±2.5)、(2.3±1.9)分,F=6.29]和精神病风险症状量表总分[(30.3±8.1)、(25.3±10.5)、(20.1±7.5)分,F=4.20]的差异具有统计学意义(均P＜0.05).进一步的方差模型检验显示,阳性症状得分每减少2.17分,APS恢复的可能性具有统计学意义(t=2.23,P＜0.05);瓦解症状每减少1.44分,APS恢复的可能性具有统计学意义(t=2.03,P＜0.05).随访6个月后,APS患者除了“个人卫生”恶化的比例(8.5％,4/47)略高于缓解的(6.4％,3/47)之外,其余所有风险症状缓解的比例均高于恶化.其中,“猜疑被害观念”(63.8％,30/47)和“心境烦躁”(68.1％,32/47)是缓解患者中所占比例最多的2个症状.结论 APS患者转化的风险较高,但大部分风险症状在短期内仍呈现趋于缓解的趋势,阳性症状和瓦解症状得分越低,预后越好.“,”Objective To investigate the dynamic symptom outcomes in individuals with attenuated psychosis syndrome (APS),and analyze the related factors influencing the outcome.Methods Sixty-three participants were identified as APS using the Structured Interview for Psychosis-Risk Syndromes from 7 research centers.Participants were administered measures of psychosis risk symptoms (Scale of Psychosis-Risk Symptoms),and followed up 6 months later.Results Of the 63 participants,47 were followed up.There were no significant difference in social demography (x2=2.30-3.28,P＞0.05) and risk symptoms (F=0.01-2.10,P＞0.05) except for age (F=5.23,P＜0.05) between the follow-up and dropout group.Among the 47 individuals,8 (17.0％) converted,18 (38.3％) maintained the APS state and 21 (44.7％)recovered.Among the three clinical outcomes,although there were no significant difference in social demography (x2=0.39-15.1,P＞0.05) and social function (F=0.71,P＞0.05) at baseline,but significant difference in positive symptoms (9.3±2.8,8.8±2.5,6.6±3.4; F=3.39,P＜0.05),disorganized symptoms (5.5±2.2,3.8±2.5,2.3± 1.9; F=6.29,P＜0.05) and Scale of Psychosis-Risk Symptoms total scores(30.3±8.1,25.3±10.5,20.1 ±7.5; F=4.20,P＜0.05).Further variance model tests showed that the positive symptoms score decreased by 2.17 points (t=2.23,P=0.031)and the disorganized symptoms score decreased by 1.44 points (t=2.03,P=-0.048),then the probability of APS recovery was statistically significant.After 6 months,in addition to the proportion of deterioration (8.5％,4/47) was slightly higher than the remission (6.4％,3/47) in personal health,almost all the remission proportion in the risk symptoms were higher than the deterioration.Among them,the suspiciousness/persecutory (63.8％,30/47) and dysphoric mood (68.1％,32/47) were the highest remission proportion of the risk symptoms.Conclusions Although the transformation risk of APS is high,but most of the risk symptoms in the short term show a trend of easing,and the lower scores of the positive symptoms or the disorganized symptoms,the prognosis may be better.