Keshavan Matcheri, Montrose Debra M, Rajarethinam Rajaprabhakaran, Diwadkar Vaibhav, Prasad Konasale, Sweeney John A
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 4201, St Antoine Blvd., Detroit, MI 48201, USA.
Schizophr Res. 2008 Aug;103(1-3):114-20. doi: 10.1016/j.schres.2008.03.006. Epub 2008 Apr 28.
A broad range of psychopathology, including externalizing disorders is seen in offspring at genetic risk for schizophrenia. However, it is unclear whether such psychopathology may underlie a higher predisposition to the premorbid antecedents of schizophrenia. We examined the prevalence and correlates of psychopathology in an ongoing study of offspring genetically at risk for schizophrenia.
Seventy five consenting high risk offspring (HR: offspring, age 15.68+/-3.27 years; male/female 34/41) and 82 matched comparison subjects (40 males and 42 females; age 15.92+/-3.0 years) participated in this study. Diagnoses were ascertained using structured psychiatric interviews and consensus meetings, including all available clinical information.
Sixty (60%) of the HR offspring had one or more lifetime diagnosis of axis I psychiatric disorder. HR subjects with axis I psychopathology had significantly more soft neurological signs, poorer premorbid adjustment, and higher schizotypy scores as measured by Chapman psychosis proneness scales. Among those with psychopathology, HR subjects with externalizing disorders showed the most abnormal scores in schizotypy.
A substantial proportion of HR offspring of parents with schizophrenia manifest a broad range of childhood psychiatric disorders. Psychopathology, especially externalizing disorders such as attention deficit hyperactivity disorder (ADHD) may represent a subgroup with an increased risk for schizophrenia spectrum disorders. This possibility needs to be examined by prospective follow-up studies, and would be of considerable importance to early diagnosis and intervention efforts in schizophrenia.
在有精神分裂症遗传风险的后代中可观察到广泛的精神病理学表现，包括外化性障碍。然而，尚不清楚这种精神病理学是否可能是精神分裂症病前先兆更高易感性的基础。我们在一项对有精神分裂症遗传风险的后代的正在进行的研究中，调查了精神病理学的患病率及其相关因素。
75名同意参与研究的高危后代（HR：后代，年龄15.68±3.27岁；男/女34/41）和82名匹配的对照受试者（40名男性和42名女性；年龄15.92±3.0岁）参与了本研究。使用结构化精神病学访谈和共识会议确定诊断，包括所有可用的临床信息。
60%的高危后代有一项或多项I轴精神障碍的终生诊断。患有I轴精神病理学的高危受试者有明显更多的软性神经体征、病前适应能力较差，并且根据查普曼精神病易感性量表测量，其精神分裂症型得分更高。在患有精神病理学的受试者中，患有外化性障碍的高危受试者在精神分裂症型方面表现出最异常的得分。
精神分裂症患者的相当一部分高危后代表现出广泛的儿童期精神障碍。精神病理学，尤其是注意力缺陷多动障碍（ADHD）等外化性障碍，可能代表了精神分裂症谱系障碍风险增加的一个亚组。这种可能性需要通过前瞻性随访研究来检验，并且对于精神分裂症的早期诊断和干预工作具有相当重要的意义。
