Sacchetti E, Calzeroni A, Vita A, Terzi A, Pollastro F, Cazzullo C L
University Service of Psychiatry, Ospedale San Paolo, Milan, Italy.
Br J Psychiatry. 1992 Mar;160:390-7. doi: 10.1192/bjp.160.3.390.
Although the excess of schizophrenic births in the winter and early spring has been replicated and some non-conclusive work supports the same seasonal birth trend in patients with major affective disorders, the aetiopathogenetic foundations of this phenomenon remain uncertain. The primary role of perinatal seasonal factors that predispose to the development of schizophrenia via induction of brain damage has been invoked, as has a tendency for patients to conceive during the spring and early summer. In order to test these two hypotheses, cerebral ventricular size and cortical atrophy in 206 schizophrenics and 107 patients with major affective disorders were assessed by CT and analysed in relation to month of birth. Compared with schizophrenics born during the remainder of the year, those born between December and April, particularly in cases lacking a family history of schizophrenia, showed increased chances for ventricular enlargement, but not for cortical atrophy. No association between season of birth and central or cortical atrophy was found for patients with major affective disorders. This suggests that the brain-damaging effect played by perinatal seasonal factors has both a disease and an anatomical specificity.
尽管冬季和早春精神分裂症患者出生人数过多的现象已被反复证实，并且一些尚无定论的研究也支持重度情感障碍患者存在同样的季节性出生趋势，但这一现象的病因学基础仍不明确。有人提出围产期季节性因素通过引发脑损伤在精神分裂症发病过程中起主要作用，也有人认为患者倾向于在春季和初夏受孕。为了验证这两种假说，通过CT对206名精神分裂症患者和107名重度情感障碍患者的脑室大小和皮质萎缩情况进行了评估，并分析了其与出生月份的关系。与一年中其他时间出生的精神分裂症患者相比，12月至4月出生的患者，尤其是那些没有精神分裂症家族史的患者，脑室扩大的几率增加，但皮质萎缩的几率并未增加。重度情感障碍患者的出生季节与中枢或皮质萎缩之间未发现关联。这表明围产期季节性因素所起的脑损伤作用具有疾病特异性和解剖学特异性。
