Myles-Worsley Marina, Blailes Francisca, Ord Lisa M, Weaver Starla, Dever Gregory, Faraone Stephen V
Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Am J Med Genet B Neuropsychiatr Genet. 2007 Jan 5;144B(1):5-9. doi: 10.1002/ajmg.b.30362.
The Palau Early Psychosis Study (PEPS) was designed to examine the pathogenesis of early psychosis in a high-risk population isolate. This paper describes the characteristics of our community-based, non-help seeking sample of 404 Palauan adolescents and quantifies the presence of early psychosis by level of genetic risk. The sample included 53 offspring of a schizophrenic parent designated as "Genetically Highest Risk" (GHR+) and 68 nieces/nephews of sib-pairs/trios, designated as "Genetically High Risk" (GHR). The remaining subjects were recruited through a high school survey that identified 62 "Genetically Moderate Risk" (GMR) adolescents with an affected second or third degree relative and 221 "Genetically Low Risk" (GLR) subjects with no close affected relatives. The GLR adolescents included 117 symptomatic or "Clinically High Risk" (CHR) adolescents and 104 asymptomatic normal controls. Based on a modified K-SADS-PL assessment, we identified 221 adolescents with early psychosis, 62 or 28% of whom had already transitioned to a psychotic disorder. Together, the two highest risk groups contributed 31% of the adolescent-onset psychosis cases and 27% of the prodromals. More than half of the early psychosis cases (53%) were GLR adolescents. The mean age of onset for DSM-IV psychosis was 12.9 years, and males transitioned at an earlier age than females. Our results indicate that Palauan adolescents, even GLR adolescents with no close affected relatives, have elevated rates of early psychosis. These young subjects can contribute valuable information about the familial transmission of schizophrenia, the developmental course of the illness, and rates of transition to frank psychosis.
帕劳早期精神病研究（PEPS）旨在研究高危人群隔离地区早期精神病的发病机制。本文描述了我们以社区为基础、未寻求帮助的404名帕劳青少年样本的特征，并根据遗传风险水平对早期精神病的存在情况进行了量化。该样本包括53名被指定为“遗传风险最高”（GHR+）的精神分裂症患者的后代，以及68名被指定为“遗传高风险”（GHR）的同胞对/三联体的侄子/侄女。其余受试者通过一项高中调查招募，该调查确定了62名有二级或三级亲属患病的“遗传中度风险”（GMR）青少年和221名没有近亲患病的“遗传低风险”（GLR）受试者。GLR青少年包括117名有症状或“临床高风险”（CHR）的青少年和104名无症状的正常对照。根据改良的K-SADS-PL评估，我们确定了221名患有早期精神病的青少年，其中62名（28%）已经转变为精神病性障碍。两个最高风险组共同构成了31%的青少年期精神病病例和27%的前驱病例。超过一半的早期精神病病例（53%）是GLR青少年。DSM-IV精神病的平均发病年龄为12.9岁，男性比女性发病更早。我们的结果表明，帕劳青少年，即使是没有近亲患病的GLR青少年，早期精神病的发病率也较高。这些年轻受试者可以提供有关精神分裂症家族传播、疾病发展过程以及向明显精神病转变率的宝贵信息。
