Biswas Parthasarathy, Malhotra Savita, Malhotra Anil, Gupta Nitin
Dept. of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
Eur Child Adolesc Psychiatry. 2006 Sep;15(6):360-6. doi: 10.1007/s00787-006-0542-7. Epub 2006 Apr 8.
Childhood onset schizophrenia (COS) patients have marked neuropsychological deficits in areas of attention, working memory and executive functions. Similar deficits have been found in studies on Adolescent onset (AdOS) and Adult onset schizophrenia (AOS). In this study we compared the neuropsychological profile of COS with AdOS and AOS to test the hypothesis that earlier the onset greater is the severity of illness and greater are the neuropsychological deficits. A sample of 15 patients of COS was compared with 20 patients each of AdOS and AOS group. Assessment of neuropsychological profile was done using standard neuropsychological battery for Indian population. Nahor Benson Test and Bender Visual Motor Gestalt Test were used to assess perceptuomotor functioning. COS patients showed significantly greater deficits on scales of IQ, memory and perceptuomotor skills as compared to AdOS that in turn had greater deficits than AOS. The persistence of differences across the three groups inspite of controlling for education and age suggest that these deficits may have been present even before the onset of illness and was not the result of poor academic achievements. These findings also point towards a brain damage in schizophrenia that occurs on a continuum of severity with COS being the most virulent, AOS being the least and AdOS falling in between these two extremes.
儿童期起病的精神分裂症(COS)患者在注意力、工作记忆和执行功能等方面存在明显的神经心理学缺陷。在青少年期起病(AdOS)和成年期起病的精神分裂症(AOS)研究中也发现了类似的缺陷。在本研究中,我们比较了COS与AdOS和AOS的神经心理学特征,以检验发病越早疾病严重程度越高且神经心理学缺陷越严重这一假设。将15例COS患者的样本与AdOS组和AOS组各20例患者进行比较。使用针对印度人群的标准神经心理学成套测验对神经心理学特征进行评估。采用纳霍·本森测验和本德尔视觉运动完形测验来评估感知运动功能。与AdOS相比,COS患者在智商、记忆和感知运动技能量表上的缺陷明显更大,而AdOS的缺陷又比AOS更大。尽管对教育程度和年龄进行了控制,但三组之间的差异仍然存在,这表明这些缺陷可能在疾病发作之前就已经存在,而不是学业成绩不佳的结果。这些发现还表明精神分裂症存在脑损伤,其严重程度呈连续变化,COS最为严重,AOS最轻,AdOS则介于这两个极端之间。