Jönsson S A, Jonsson H
Department of Psychiatry and Neurochemistry, University of Lund, Sweden.
Acta Psychiatr Scand. 1992 Oct;86(4):287-95. doi: 10.1111/j.1600-0447.1992.tb03268.x.
In search of features of prognostic importance, a cohort of patients admitted to a mental hospital in 1925 was investigated by means of multivariate clustering techniques. Using K-means cluster analysis or Q-factor analysis, a group containing cases with unfavourable prognosis was isolated. Other groups derived were prognostically heterogeneous. One group of patients, in early phases similar to good prognosis schizoaffective psychoses, could be distinguished and characterized by non-symptom items. There was initial periodicity and onset was acute. They were, on average, younger than the other subjects and there was no personality deviation or emotional disturbance before onset of disease. A family history of mental illness was rare. Two of the factors were positively and negatively characterized by items covering familial history of mental illness, thus seemingly confirming the familial vs sporadic distinction in the subclassification of schizophrenia. Though the clinical pictures were distinctively different at the time when the ratings underlying the analysis were made, approximately the same proportion of cases in the two groups had independently been diagnosed as paranoid schizophrenia--also taking the course of illness into account. It could furthermore be shown that the population at risk--siblings and children of subjects--as well as the observed number of years at risk in these groups were significantly smaller in the sporadic group than in the familial group. This was a combined effect of a lower fertility in subjects and parents in the sporadic group and a higher rate of drop out due to mortality and other reasons among siblings of these subjects. The same tendency was indicated when subjects with and without family history irrespective of factor belongingness were compared. It cannot be concluded that the familial vs sporadic distinction is without relevance in the research on schizophrenia, but its essence may easily be obscured, if the population at risk is not taken into account.
为了寻找具有预后重要性的特征，采用多变量聚类技术对1925年入住一家精神病院的一组患者进行了调查。使用K均值聚类分析或Q因子分析，分离出一组预后不良的病例。其他衍生组在预后方面具有异质性。可以区分出一组患者，他们在早期阶段类似于预后良好的精神分裂症情感性精神病，并通过非症状项目进行特征描述。发病初期有周期性且起病急。他们平均比其他受试者年轻，发病前没有人格偏差或情绪障碍。精神疾病家族史很少见。其中两个因素分别以涵盖精神疾病家族史的项目进行正向和负向特征描述，从而似乎证实了精神分裂症亚分类中家族性与散发性的区别。尽管在进行分析所依据的评级时临床症状明显不同，但两组中大约相同比例的病例在考虑疾病病程的情况下也独立被诊断为偏执型精神分裂症。此外，可以证明，散发性组中处于风险中的人群（受试者的兄弟姐妹和子女）以及这些组中观察到的风险年数明显少于家族性组。这是散发性组中受试者及其父母生育率较低以及这些受试者的兄弟姐妹因死亡和其他原因退出率较高的综合结果。比较有家族史和无家族史的受试者（无论所属因素如何）时也显示出相同的趋势。不能得出家族性与散发性的区别在精神分裂症研究中无关紧要的结论，但如果不考虑处于风险中的人群，其本质可能很容易被掩盖。
