Cannon T D, Mednick S A, Parnas J
Social Science Research Institute, University of Southern California, Los Angeles 90089-MC-1111.
Arch Gen Psychiatry. 1990 Jul;47(7):622-32. doi: 10.1001/archpsyc.1990.01810190022003.
We reanalyzed the Copenhagen schizophrenia high-risk project data set to test recently developed models of the antecedents of predominantly negative and predominantly positive forms of schizophrenia. Among a group of 138 high-risk individuals, those at elevated genetic risk who suffered severe delivery complications and who were autonomic nonresponders during adolescence were significantly more likely than those without this pattern to evidence outcomes of schizophrenia with predominantly negative symptoms (86% vs 0.8%, respectively). Among a group of 160 high-risk subjects, those who escaped delivery complications, who evidenced a high degree of autonomic responsiveness in adolescence, and who experienced severe disruption of the early family rearing environment were significantly more likely than those without this pattern to evidence outcomes of schizophrenia with predominantly positive symptoms (40% vs 1.2%, respectively). In late childhood and early adolescence, predominantly negative-symptom schizophrenics were rated by their teachers as passive, socially isolated, and unresponsive to praise; predominantly positive-symptom schizophrenics were rated as overactive, irritable, distractible, and aggressive. The study is limited by the fact that the hypotheses were based in part on previous analyses of the same data set, by the small number of schizophrenic subjects of each subtype, and by the use of simplified theoretical and statistical models that do not address the multidetermination of negative and positive symptoms.
我们重新分析了哥本哈根精神分裂症高危项目数据集，以检验最近开发的关于以阴性症状为主和以阳性症状为主的精神分裂症发病因素的模型。在一组138名高危个体中，那些遗传风险较高、分娩时出现严重并发症且在青春期自主神经无反应的个体，比没有这种情况的个体更有可能出现以阴性症状为主的精神分裂症结局（分别为86%和0.8%）。在一组160名高危受试者中，那些未出现分娩并发症、在青春期表现出高度自主神经反应性且早期家庭养育环境受到严重干扰的个体，比没有这种情况的个体更有可能出现以阳性症状为主的精神分裂症结局（分别为40%和1.2%）。在儿童晚期和青春期早期，以阴性症状为主的精神分裂症患者被教师评为被动、社交孤立且对赞扬无反应；以阳性症状为主的精神分裂症患者被评为活动过度、易怒、注意力分散且具有攻击性。该研究存在一定局限性，即这些假设部分基于对同一数据集的先前分析，各亚型精神分裂症患者数量较少，且使用了简化的理论和统计模型，未涉及阴性和阳性症状的多因素决定。
