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超越症状维度:通过潜在类别分析得出的精神分裂症患者群体的风险因素。

Beyond symptom dimensions: schizophrenia risk factors for patient groups derived by latent class analysis.

机构信息

Division of Psychiatry, Nottingham University, A floor, South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK.

出版信息

Schizophr Res. 2009 Dec;115(2-3):346-50. doi: 10.1016/j.schres.2009.09.017. Epub 2009 Oct 18.

Abstract

INTRODUCTION

Patients grouped by latent class analysis of symptoms show some consensus between studies, and may be less etiologically heterogeneous than current diagnoses. If so, the effect size of 'neurodevelopmental' risk factors may be greater than in equivalent DSMIV diagnostic groups.

METHOD

Two hundred fifty six individuals with neurodevelopmental risk factors recorded in the National Child Development Study (1958) UK birth cohort were grouped by data-driven illness subtypes, derived previously in over 1000 individuals. The effect sizes of these risks were compared between data-derived and DSMIV schizophrenia (295.x) groups.

RESULTS

Compared to DSMIV schizophrenia, the data-driven subtype broadly characterized by the presence of psychotic symptoms in the absence of affective symptoms showed significantly greater effect sizes in eight out of thirteen continuously-rated risk factors: birth weight, cognition, childhood behavioural problems, and neurological softsigns including handedness.

CONCLUSION

A data-driven subgroup of schizophrenia patients, characterized as lacking co-morbid depressive symptoms, is less heterogeneous with respect to neurodevelopmental etiology.

摘要

简介

通过对症状进行潜在类别分析而分组的患者在研究之间显示出一定的一致性,并且可能比当前的诊断在病因学上具有更少的异质性。如果是这样,那么“神经发育”危险因素的效应大小可能大于等效的 DSM-IV 诊断组。

方法

通过对英国出生队列的全国儿童发展研究(1958 年)中记录的 256 名具有神经发育危险因素的个体进行数据驱动的疾病亚型分组,这些亚型先前在 1000 多名个体中得到了验证。将这些风险的效应大小与 DSM-IV 精神分裂症(295.x)组进行比较。

结果

与 DSM-IV 精神分裂症相比,数据驱动的亚型广泛表现为存在精神病症状而无情感症状,在十三个连续评分的风险因素中有八个表现出显著更大的效应大小:出生体重、认知、儿童行为问题以及包括利手在内的神经软体征。

结论

精神分裂症患者的一个数据驱动亚组,其特征是缺乏共病抑郁症状,在神经发育病因学方面具有较少的异质性。

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