Squires-Wheeler E, Skodol A E, Erlenmeyer-Kimling L
Department of Medical Genetics, Columbia University, College of Physicians and Surgeons, New York, NY 10032.
Schizophr Res. 1991 Dec;6(1):75-85. doi: 10.1016/0920-9964(91)90023-k.
The expression of schizotypal personality traits was assessed in mid-adolescence and again in young adulthood for three groups of offspring defined by the psychiatric diagnosis of their parents. Parental diagnoses included schizophrenic disorder (47 offspring), affective disorder (39 offspring), and 'no psychiatric disorder', or normal controls (82 offspring). Initially, schizotypal traits were assessed from video-taped semi-structured psychiatric interviews, subsequently rated by trained psychiatrists blind to the parental psychiatric status of the subjects, and/or direct clinical interviews (Schedule for Affective Disorders-Lifetime Version (SADS-L)). The second assessment was conducted by trained social workers and psychologists by means of a semi-structured interview specifically for DSM-III-R personality disorders (Personality Disorder Examination) and sections of the SDS-L where indicated. These interviewers were blind to the parental status and to previous psychiatric assessments of the offspring. The rates of stability of features or the rates of progression to axis I psychotic disorders (Schizophrenia, Schizoaffective Disorder, and Unspecified Functional Psychosis) were evaluated. Concordance of assessments over time is reported as a function of threshold for expression of traits at initial evaluation, i.e., two or more, three or more, or four or more features present. Concordance increases as the threshold for expression increases, as expected. The effect of comorbid clinical status, e.g., the coexistence of schizotypal traits and anxiety and/or depressive features on the concordance pattern, is also examined by parental diagnostic group status. The offspring of affective disorder parents exhibited higher rates of anxiety and/or depressive features at both points in time, exhibited higher concordance for anxiety and/or depressive features, and exhibited higher rates of 'transformation' of initial schizotypal features to anxiety and/or depressive features at the second assessment.
对三组根据其父母的精神科诊断所定义的后代，在青春期中期和成年早期分别评估了分裂型人格特质的表达情况。父母的诊断包括精神分裂症（47名后代）、情感障碍（39名后代）以及“无精神障碍”，即正常对照组（82名后代）。最初，分裂型特质通过录像的半结构化精神科访谈进行评估，随后由对受试者父母精神状态不知情的训练有素的精神科医生进行评分，和/或通过直接临床访谈（情感障碍终身版日程表（SADS-L））进行评估。第二次评估由训练有素的社会工作者和心理学家通过专门针对《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）人格障碍的半结构化访谈（人格障碍检查）以及在需要时通过SDS-L的部分内容进行。这些访谈者对父母的状况以及后代先前的精神科评估不知情。评估了特征的稳定性比率或发展为轴I精神病性障碍（精神分裂症、分裂情感性障碍和未特定的功能性精神病）的比率。随着时间推移的评估一致性作为初始评估时特质表达阈值的函数进行报告，即存在两个或更多、三个或更多或四个或更多特征。正如预期的那样，随着表达阈值的增加，一致性也增加。还通过父母诊断组状况检查了共病临床状态的影响，例如分裂型特质与焦虑和/或抑郁特征共存对一致性模式的影响。情感障碍父母的后代在两个时间点都表现出更高的焦虑和/或抑郁特征发生率，表现出更高的焦虑和/或抑郁特征一致性，并且在第二次评估时表现出更高的初始分裂型特征“转变”为焦虑和/或抑郁特征的比率。
