Naudts Kris, Hodgins Sheilagh
Department of Forensic Mental Health Science, Institute of Psychiatry, King's College London, London, UK.
Curr Opin Psychiatry. 2006 Sep;19(5):533-8. doi: 10.1097/01.yco.0000238484.12023.aa.
Compelling evidence suggests that a small group of men who develop schizophrenia display a stable pattern of antisocial behaviour from childhood onwards, causing considerable suffering to victims and to themselves and imposing a significant financial burden on society. We reviewed the literature on the neurobiological correlates of antisocial behaviour and violence to further the understanding of this subgroup of persons with schizophrenia and develop testable hypotheses for future research.
Few studies have been conducted, sample sizes are small and measures vary greatly. Taken together, the results suggest that among men with schizophrenia, those who have displayed a stable pattern of antisocial and aggressive behaviour since childhood, as compared with those with no such history, perform better on neuropsychological tests tapping specific executive functions and more poorly on assessments of orbitofrontal functions. We hypothesize that individuals in this subgroup are less compromised neurologically and display structural brain abnormalities in the amygdala-orbitofrontal system and in the prefrontal cortex and hippocampus.
A better understanding of the distinctive neurobiological characteristics of this subgroup of men with schizophrenia will contribute to developing treatments tailored to their needs, to prevent antisocial behaviours and to reduce the symptoms of schizophrenia.
有力证据表明，一小部分患精神分裂症的男性从童年起就表现出稳定的反社会行为模式，给受害者和他们自己都带来了相当大的痛苦，并给社会造成了巨大的经济负担。我们回顾了关于反社会行为和暴力的神经生物学相关性的文献，以进一步了解这一精神分裂症亚组人群，并为未来研究提出可检验的假设。
相关研究较少，样本量小且测量方法差异很大。综合来看，结果表明，在患有精神分裂症的男性中，那些自童年起就表现出稳定的反社会和攻击行为模式的人，与没有这种历史的人相比，在测试特定执行功能的神经心理学测试中表现较好，而在眶额功能评估中表现较差。我们假设，这一亚组中的个体神经功能受损较轻，并且在杏仁核 - 眶额系统、前额叶皮质和海马体中表现出结构性脑异常。
更好地了解这一精神分裂症男性亚组独特的神经生物学特征，将有助于开发针对他们需求的治疗方法，预防反社会行为，并减轻精神分裂症的症状。
