Brewer W J, Pantelis C, Anderson V, Velakoulis D, Singh B, Copolov D L, McGorry P D
Cognitive Neuropsychiatry Research, University of Melbourne, Parkville, Melbourne, Australia.
Am J Psychiatry. 2001 Jan;158(1):107-15. doi: 10.1176/appi.ajp.158.1.107.
Olfactory identification deficits and their relationship to negative symptoms in patients with schizophrenia were examined in patients with recent-onset psychosis, the majority of whom were neuroleptic naive.
Seventy-four inpatients with a first episode of psychosis (27 with schizophrenia or schizophreniform disorder, nine with schizoaffective disorder, 17 with affective psychoses, and 21 with other psychoses), 49 of whom had not received antipsychotic medication, were compared to 38 age- and gender-matched normal subjects. Olfactory identification ability was assessed with the University of Pennsylvania Smell Identification Test. Forty patients and 13 comparison subjects were reassessed at 6 months to examine whether olfactory deficits were specific to schizophrenia or schizophreniform disorder and were stable over time.
At baseline, the patients had significant impairment in olfactory identification ability compared to the normal subjects. This difference persisted after controlling for gender, premorbid or current IQ, smoking history, cannabis use, or the effects of medication. Diagnostic subgroups did not differ in olfactory identification ability. The deficits remained stable at 6-month follow-up and were associated with negative symptoms at both time points. No relationship was found between olfactory identification ability and length of either untreated psychosis or illness prodrome.
Impairment in olfactory identification ability was apparent from the outset of psychotic illness and was not specific to schizophrenia or schizophreniform disorder. No change in the degree of this deficit was found after patients were stabilized and had responded to medication. The deficit could not be explained by peripheral factors that might contribute to olfactory identification ability, suggesting that it reflects central mechanisms.
在近期发病的精神病患者中研究嗅觉识别缺陷及其与精神分裂症患者阴性症状的关系，这些患者大多数未使用过抗精神病药物。
将74例首次发作精神病的住院患者（27例精神分裂症或精神分裂症样障碍、9例分裂情感性障碍、17例情感性精神病、21例其他精神病）与38例年龄和性别匹配的正常受试者进行比较，其中49例未接受过抗精神病药物治疗。用宾夕法尼亚大学嗅觉识别测试评估嗅觉识别能力。40例患者和13例对照受试者在6个月时进行重新评估，以检查嗅觉缺陷是否为精神分裂症或精神分裂症样障碍所特有，以及是否随时间稳定。
在基线时，与正常受试者相比，患者的嗅觉识别能力有显著损害。在控制了性别、病前或当前智商、吸烟史、大麻使用或药物影响后，这种差异仍然存在。各诊断亚组在嗅觉识别能力上没有差异。这些缺陷在6个月的随访中保持稳定，并且在两个时间点都与阴性症状相关。未发现嗅觉识别能力与未治疗精神病或疾病前驱期的时长之间存在关联。
嗅觉识别能力的损害在精神病发作之初就很明显，并非精神分裂症或精神分裂症样障碍所特有。患者病情稳定并对药物产生反应后，这种缺陷的程度没有变化。这种缺陷不能用可能影响嗅觉识别能力的外周因素来解释，提示其反映的是中枢机制。
