Stone William S, Hsi Xiaolu, Tan Liwen, Zhu Shaochun, Li Lingjiang, Giuliano Anthony J, Seidman Larry J, Tsuang Ming T
Department of Psychiatry, Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA, USA.
Asian J Psychiatr. 2012 Mar;5(1):83-92. doi: 10.1016/j.ajp.2011.11.007.
Many first-degree relatives of patients with schizophrenia demonstrate deficits in neurocognitive, social, clinical and other dimensions, in the absence of psychosis. Based on a reformulation of Meehl's concept of "schizotaxia" as a clinically meaningful syndrome reflecting liability to schizophrenia, we proposed research criteria in relatives focused on negative symptoms and neurocognitive deficits. Here we assess validity of the syndrome in a sample of Chinese adult relatives by assessing measures of concurrent validity, and by using cluster analysis to test the hypothesis that relatives could be grouped into distinct schizotaxic and non-schizotaxic subgroups based on our diagnostic criteria. Thirty community comparison subjects (CCS) and 189 relatives were evaluated with measures of clinical, cognitive, medical and social function at the Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha (Hunan, China), as part of a larger study to identify and ameliorate symptoms of schizotaxia. Using modified research criteria based on negative symptoms and neurocognitive deficits, 103 relatives did not meet criteria for schizotaxia, and 86 did. The cluster analysis confirmed a two-group solution that corresponded to our non-schizotaxic and schizotaxic groups, but it increased the non-schizotaxic group to 135, and reduced the schizotaxic group to 53. Both schizotaxic groups, but especially the cluster-derived group, showed significant impairment in a variety of independent (i.e. non-criterion related) measures of clinical and social function. These findings provide additional validity for a liability syndrome, and for its utility as an intervention target for strategies aimed at ameliorating both its core and its associated symptoms.
许多精神分裂症患者的一级亲属在无精神病症状的情况下，在神经认知、社会、临床及其他方面存在缺陷。基于将米尔的“分裂性素质”概念重新阐释为一种反映精神分裂症易感性的具有临床意义的综合征，我们提出了针对亲属的研究标准，重点关注阴性症状和神经认知缺陷。在此，我们通过评估同时效度指标，并使用聚类分析来检验基于我们的诊断标准亲属可被分为不同的分裂性素质组和非分裂性素质组这一假设，从而在中国成年亲属样本中评估该综合征的效度。作为一项旨在识别和改善分裂性素质症状的更大规模研究的一部分，在中南大学湘雅二医院精神卫生研究所（中国湖南长沙），对30名社区对照受试者（CCS）和189名亲属进行了临床、认知、医学和社会功能评估。使用基于阴性症状和神经认知缺陷的修订研究标准，103名亲属未达到分裂性素质标准，86名达到标准。聚类分析确认了一个两组解决方案，与我们的非分裂性素质组和分裂性素质组相对应，但非分裂性素质组增加到135人，分裂性素质组减少到53人。两个分裂性素质组，尤其是聚类衍生组，在各种独立的（即与标准无关的）临床和社会功能指标上均表现出显著损害。这些发现为一种易感性综合征及其作为旨在改善其核心症状和相关症状的干预靶点的效用提供了额外的效度依据。
