Walker Jenny, Curtis Vivienne, Shaw Philip, Murray Robin M.
Institute of Psychiatry, Maudsley Hospital, Denmark Hill, London, UK.
Neurotox Res. 2002 Aug-Sep;4(5-6):427-436. doi: 10.1080/1029842021000022070.
This paper examines the commonalities and the differences between schizophrenia and bipolar disorder. Recent studies suggest a possible overlap in genetic susceptibility to the two conditions. However, while the influence of early environmental effects, particularly obstetric complications, has been established for schizophrenia, no such replicable association with bipolar disorder has been found. Structural abnormalities of the brain have been identified in both schizophrenia and bipolar disorder, but while the volume of the amygdala and hippocampus appears decreased in schizophrenia, this is not the case in bipolar disorder; indeed there are some suggestions of increased volume of the amygdala. Furthermore, schizophrenia is characterised by lower IQ, executive function and verbal memory, but there is little evidence of trait neuropsychological deficits in bipolar disorder. Similarly, premanic children do not show the cognitive and neuromotor impairments characteristic of those destined to develop schizophrenia. The most plausible explanation is that the two conditions share some genetic predisposition but differ in that schizophrenia but not bipolar disorder is subject to additional genes or early environmental hazards causing neurodevelopmental impairment.
本文探讨了精神分裂症和双相情感障碍之间的共性与差异。近期研究表明，这两种疾病在遗传易感性方面可能存在重叠。然而，虽然已证实早期环境影响，尤其是产科并发症对精神分裂症有影响，但尚未发现双相情感障碍与之有可重复的关联。在精神分裂症和双相情感障碍中均已发现大脑结构异常，但在精神分裂症中杏仁核和海马体体积似乎减小，而双相情感障碍并非如此；实际上，有一些迹象表明杏仁核体积增大。此外，精神分裂症的特征是智商、执行功能和言语记忆较低，但双相情感障碍几乎没有特质神经心理学缺陷的证据。同样，躁狂发作前的儿童不会表现出那些注定会发展为精神分裂症的儿童所特有的认知和神经运动损伤。最合理的解释是，这两种疾病有一些共同的遗传易感性，但不同之处在于，精神分裂症而非双相情感障碍会受到导致神经发育障碍的其他基因或早期环境危害的影响。
