Fleischhaker Christian, Schulz Eberhard, Tepper Kathrin, Martin Matthias, Hennighausen Klaus, Remschmidt Helmut
Department of Child and Adolescent Psychiatry, Albert Ludwigs University Freiburg, Hauptstr. 8, D-79104 Freiburg, Germany.
Schizophr Bull. 2005 Jul;31(3):769-80. doi: 10.1093/schbul/sbi014. Epub 2005 Feb 16.
Our study investigated premorbid functioning, course, and outcome in early-onset schizophrenia. All inpatients with DSM-III-R diagnoses of schizophrenia (n = 101) consecutively admitted between 1983 and 1988 to the Department of Child and Adolescent Psychiatry at the University of Marburg in Germany were included. To assess premorbid adaptation and precursor symptoms, we administered the Instrument for the Retrospective Assessment of the Onset of Schizophrenia, which we modified to assess children and adolescents. Symptomatology was measured by the Scale for the Assessment of Negative Symptoms, the Scale for the Assessment of Positive Symptoms, and the Brief Psychiatric Rating Scale. In addition, the Global Assessment of Functioning was applied. Followup data for 81 patients (80.2%) were available. The mean duration of schizophrenia at followup was 9.5 +/- 2.2 years. Assessment of the highest level of adaptive functioning revealed very good or good outcome in 19.8 percent of the patients, fair or poor outcome in 38.2 percent, and very poor outcome and gross impairment in 42.0 percent. Premorbid adjustment was the best predictor of outcome in our schizophrenia sample. A poor prognosis was found in patients with premorbid developmental delays and those who were introverted and withdrawn before their psychotic state.
我们的研究调查了早发性精神分裂症的病前功能、病程及预后。纳入了1983年至1988年间连续入住德国马尔堡大学儿童与青少年精神病学系、被诊断为DSM-III-R精神分裂症的所有住院患者（n = 101）。为评估病前适应情况和前驱症状，我们使用了经修改以评估儿童和青少年的精神分裂症发病回顾性评估工具。症状学通过阴性症状评估量表、阳性症状评估量表及简明精神病评定量表进行测量。此外，还应用了功能总体评定量表。有81例患者（80.2%）的随访数据可用。随访时精神分裂症的平均病程为9.5±2.2年。对最高适应功能水平的评估显示，19.8%的患者预后非常好或良好，38.2%的患者预后一般或较差，42.0%的患者预后非常差且有严重损害。在我们的精神分裂症样本中，病前调整是预后的最佳预测指标。病前有发育迟缓以及在精神病状态出现之前性格内向和孤僻的患者预后较差。
