Müller Norbert, Riedel Michael, Zawta Patricia, Günther Wilfried, Straube Andreas
Hospital for Psychiatry and Psychotherapy, Ludwig-Maximilian University, Nussbaumstrasse 7, D-80336 Munich 2, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2002 Dec;26(7-8):1245-52. doi: 10.1016/s0278-5846(02)00260-9.
The authors report on five patients who first developed Tourette's syndrome (TS) and later schizophrenia with the typical positive and negative symptoms; all five had an unfavorable course of schizophrenia. These observations as well as other reported cases raise the question of whether both disorders may share a common background. This is discussed under the aspects of similar symptomatology (echolalia, motor symptoms, cognitive deficits, obsessive-compulsive symptoms), similar pathophysiological signs, genetics and signs of an underlying inflammatory process in subgroups of cases, as well as common therapeutic strategies. A genetically determined susceptibility could possibly underlie both disorders, e.g., an autoimmunologically triggered inflammation or a common pathophysiology of certain symptoms. Both disorders show disturbances of the multiple functional pathways, which seem to be involved in the pathophysiology of both. The clinical overlap of TS and of schizophrenia may be due to a final common pathophysiological pathway.
作者报告了5例患者，他们最初患抽动秽语综合征（TS），后来发展为伴有典型阳性和阴性症状的精神分裂症；所有5例患者的精神分裂症病程均不佳。这些观察结果以及其他报告的病例提出了一个问题，即这两种疾病是否可能有共同的背景。本文从相似的症状学（模仿言语、运动症状、认知缺陷、强迫症状）、相似的病理生理体征、遗传学以及部分病例亚组中潜在炎症过程的迹象，以及共同的治疗策略等方面进行了讨论。遗传决定的易感性可能是这两种疾病的基础，例如，自身免疫引发的炎症或某些症状的共同病理生理学。这两种疾病都表现出多种功能通路的紊乱，这似乎与两者的病理生理学都有关。TS和精神分裂症的临床重叠可能归因于最终的共同病理生理途径。
