Department of Physiology and Biophysics, National Defense Medical Center, No 161, Section 6, Min-Chuan East Road, Taipei 114, Taiwan.
BMC Psychiatry. 2010 Aug 18;10:63. doi: 10.1186/1471-244X-10-63.
Over the last few decades, research regarding the age of onset of schizophrenia and its relationship with other clinical variables has been incorporated into clinical practices. However, reports of potential differences in demographic and clinical characteristics between early- and adult-onset schizophrenia spectrum disorders have been controversial. Thus, this study aims to assess differences in demographic and clinical characteristics correlated with age of illness onset in schizophrenia spectrum disorders.
Data were collected from 104 patients with schizophrenia and schizoaffective disorder. Diagnosis was made via structured clinical interviews. Assessments of psychiatric symptoms and social and global functioning were completed. The effect of age of onset on demographic and clinical variables was examined using correlation analyses and binary logistic regression models. We chose 17 years of age as the cut-off for early-onset schizophrenia spectrum disorders based on a recent clinical consensus. We further investigated differences in the severity of psychopathology and other clinical variables between the early- and adult-onset groups.
The binary logistic regression analysis showed that age of onset was significantly related to the cognitive component of the Positive and Negative Syndrome Scale (PANSS) (odds ratio, OR = 0.58; 95% confidence interval, CI = 0.872-0.985; p < 0.001) and Barratt Impulsiveness Scale (BIS) score (OR = 0.94; 95% CI = 0.447-0.744; p = 0.015). Patients with early onset of schizophrenia spectrum disorders had significantly greater levels of cognitive impairment and higher impulsivity. There were significant differences between several demographic and clinical variables, including the negative symptom component of the PANSS (p < 0.001), cognitive component of the PANSS (p < 0.001), BIS score (p = 0.05), and psychological domain of quality of life (QOL) (p = 0.05), between patients with early- and adult-onset schizophrenia spectrum disorders, having controlled for the effect of the current age and duration of illness.
Our findings support the hypothesis of an influence of age of onset on illness course in patients with schizophrenia spectrum disorders. This finding may in fact be part of a separate domain worthy of investigation for the development of interventions for early symptoms of schizophrenia.
在过去几十年中，关于精神分裂症发病年龄及其与其他临床变量关系的研究已纳入临床实践。然而，关于早发性和成年发病精神分裂症谱系障碍之间在人口统计学和临床特征方面可能存在差异的报告一直存在争议。因此，本研究旨在评估精神分裂症谱系障碍发病年龄与疾病相关的人口统计学和临床特征之间的差异。
本研究共纳入 104 例精神分裂症和分裂情感障碍患者。通过结构临床访谈进行诊断。完成了精神病症状和社会及总体功能的评估。使用相关分析和二元逻辑回归模型检查了发病年龄对人口统计学和临床变量的影响。我们根据最近的临床共识，选择 17 岁作为早发性精神分裂症谱系障碍的截断值。我们进一步研究了早发性和成年发病组之间精神病理学严重程度和其他临床变量的差异。
二元逻辑回归分析表明，发病年龄与阳性和阴性症状量表（PANSS）的认知成分（优势比，OR=0.58；95%置信区间，CI=0.872-0.985；p<0.001）和巴雷特冲动量表（BIS）评分（OR=0.94；95%置信区间，CI=0.447-0.744；p=0.015）显著相关。早发性精神分裂症谱系障碍患者的认知障碍程度明显更高，冲动性更高。在人口统计学和临床变量方面存在显著差异，包括 PANSS 的阴性症状成分（p<0.001）、PANSS 的认知成分（p<0.001）、BIS 评分（p=0.05）和生活质量（QOL）的心理领域（p=0.05），这些差异在控制了当前年龄和疾病持续时间的影响后仍然存在。
我们的研究结果支持了发病年龄对精神分裂症谱系障碍患者疾病过程的影响的假说。这一发现实际上可能是值得进一步研究的一个单独领域，以便为精神分裂症的早期症状开发干预措施。
