Walker E F, Diforio D, Baum K
Department of Psychology, Emory University, Atlanta, GA 30322, USA.
Acta Psychiatr Scand Suppl. 1999;395:12-9. doi: 10.1111/j.1600-0447.1999.tb05978.x.
Changes in the manifestation of vulnerability to schizophrenia across the lifespan may hold important clues about aetiology. They may also illustrate some general principles about the nature of neurodevelopmental processes. Within the framework of a neural diathesis-stress model, we review findings on the precursors of schizophrenia and schizotypal personality disorder. The findings suggest that there are critical developmental periods for the manifestation of dysfunction and that, within certain domains of behaviour, there is a temporal disjunction between the onset of the neuropathology and its expression. It also appears that the diathesis for schizophrenia involves polymorphic behavioural expression, such that it can be manifested in multiple domains - motoric, cognitive and socio-emotional. Taken together, the data on the longitudinal course of schizophrenia indicate that the expression of the diathesis is moderated by central nervous system maturational processes. One putative moderating system, the hypothalamic-pituitary-adrenal (HPA) axis, is discussed, and implications for preventive intervention are explored.
精神分裂症易感性在整个生命周期中的表现变化可能蕴含着有关病因的重要线索。它们还可能阐明一些关于神经发育过程本质的一般原则。在神经素质-应激模型的框架内，我们回顾了精神分裂症和分裂型人格障碍前驱症状的研究结果。研究结果表明，功能障碍的表现存在关键的发育时期，并且在某些行为领域内，神经病理学的发作与其表现之间存在时间上的脱节。似乎精神分裂症的素质涉及多态性的行为表达，因此它可以在多个领域表现出来——运动、认知和社会情感领域。综合来看，关于精神分裂症纵向病程的数据表明，素质的表达受到中枢神经系统成熟过程的调节。我们讨论了一个假定的调节系统，即下丘脑-垂体-肾上腺（HPA）轴，并探讨了其对预防性干预的意义。
