Objective To analyze the factors influencing the rehabilitation effect of patients with acute first-episode schizophrenia(SCZ),and to construct a nomogram prediction model.Methods A total of 129 patients with acute first-episode SCZ treated from May 2020 to May 2023 were selected,all of whom were treated with conventional antipsychotics.At 8 weeks after treatment,the rehabilitation effect was evaluated,and the patients were divided into a poor effect group(n=40)and a good effect group(n=89).The general data and laboratory indicators of the two groups before treatment were com-pared,and the influencing factors of rehabilitation effect were analyzed by Lasso-logistic regression.A nomogram prediction model for poor rehabilitation effect of the acute first-episode SCZ patients was constructed according to the influencing factors.The predictive efficacy and clinical effectiveness of the model were evaluated by receiver operating characteristic(ROC)curve and decision curve.Results In129 patients with acute first-episode SCZ,the adverse effect rate was 31.01%(40/129).The proportion of family history of psychosis,positive and negative symptom scale(PANSS)scores,serum leptin to adiponec-tin ratio,prolactin,glial fibrin acid protein(GFAP),interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis fac-tor-α(TNF-α)in the poor effect group were higher than those in the good effect group before treatment,whereas age,educa-tion level,employment ratio of working status,MATRICS consensus cognitive battery(MCCB)score of SCZ,serum brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)levels were lower than those in good effect group before treatment(P＜0.05,P＜0.01).Lasso-logistic regression analysis showed that age,education level,PANSS score before treat-ment,MCCB score,serum leptin to adiponectin ratio,prolactin,GFAP,IL-1β,IL-6,and TNF-α level are all factors that af-fected the rehabilitation effect of patients with acute first-episode SCZ(P＜0.05,P＜0.01).A nomogram prediction model was constructed according to the influencing factors,and the area under the ROC curve of this model to predict the adverse rehabili-tation effect of patients with acute first-episode SCZ was 0.897(95%CI:0.841,0.953),which had high prediction efficiency and good clinical effectiveness.Based on the nomogram prediction model,the risk level standard for adverse rehabilitation effect in patients with acute first-episode SCZ was established,suggesting that the higher the risk level,the greater the risk of adverse rehabilitation effect(P＜0.01).Conclusion The recovery effect of patients with acute first-episode SCZ was closely related to age,education level,PANSS score,MCCB score,serum leptin to adiponectin ratio,prolactin,GFAP,IL-1β,IL-6 and TNF-α levels before treatment.The nomogram prediction model constructed according to the above influencing factors has high predic-tive efficiency and clinical effectiveness in predicting the adverse rehabilitation effects of patients.
SchizophreniaFirst-episodeAcute stageRehabilitation effectAnalysis of influencing factorsA no-mogramPrediction model
万方数据
维普
