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儿童及青少年期精神分裂症

Schizophrenia in childhood and adolescence.

作者信息

Mala Eva

机构信息

Psychiatric outpatient office, Department of Neurology, Charles University, 1st Faculty of Medicine, Prague, Czech Republic.

出版信息

Neuro Endocrinol Lett. 2008 Dec;29(6):831-6.

Abstract

Schizophrenia is a disorder characterized by delay in neurodevelopment and by a central disorder of recognition (i.e. with generalized cognitive deficit). Connectivity impairments in the areas of the social brain and cerebellum are the "messenger" of abnormal CNS development in schizophrenia. Processes of neuronal reorganization in cortical and subcortical structures, aberrant forms of pruning, sprouting, and myelinization may play a major role in the pathogenesis of a schizophrenic breakdown. Models of neuroplasticity during adolescence can be connected with models of neurodevelopmental vulnerability and models of neurotoxicity to form an integrated approach in order to better understand premorbid adjustment, onset, and course of schizophrenia. The loss of plasticity and aberrant myelinization lead to a deterioration in cognitive functions, social dysfunction and, in individuals with specific genetic vulnerability, to expression of schizophrenia. This article discusses brain development in relation to the diagnosis of schizophrenia and the basic symptoms of childhood schizophrenia (with early and very early onset) and of adolescent schizophrenia.

摘要

精神分裂症是一种以神经发育延迟和中枢识别障碍(即伴有广泛性认知缺陷)为特征的疾病。社交脑区和小脑区域的连接障碍是精神分裂症中枢神经系统异常发育的“信使”。皮质和皮质下结构中的神经元重组过程、异常形式的修剪、发芽和髓鞘形成可能在精神分裂症发作的发病机制中起主要作用。青春期的神经可塑性模型可以与神经发育易感性模型和神经毒性模型相联系,形成一种综合方法,以便更好地理解精神分裂症的病前适应、发病和病程。可塑性丧失和异常髓鞘形成导致认知功能恶化、社会功能障碍,并且在具有特定遗传易感性的个体中导致精神分裂症的表现。本文讨论了与精神分裂症诊断相关的大脑发育以及儿童期精神分裂症(早发和极早发)和青少年期精神分裂症的基本症状。

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