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性别在精神分裂症亚型识别中的作用:一种潜在类别分析方法。

The role of gender in identifying subtypes of schizophrenia: a latent class analytic approach.

作者信息

Goldstein J M, Santangelo S L, Simpson J C, Tsuang M T

机构信息

Brockton/West Roxbury VA Medical Center, Psychiatry Service, MA 02401.

出版信息

Schizophr Bull. 1990;16(2):263-75. doi: 10.1093/schbul/16.2.263.

Abstract

Past literature suggests that schizophrenic men and women may be at different risks for developing different subtypes of schizophrenia. This hypothesis was tested using data from the well-known retrospective cohort family studies, the Iowa 500 and the Iowa non-500. The sample consisted of 171 male and 161 female DSM-III schizophrenic patients and 713 of their first-degree relatives. First, bivariate tests for gender differences were conducted regarding family morbidity, age of onset, premorbid history, season of birth, and expression of deficit and affective symptoms. Restricted maximum likelihood latent class analysis was then used to test whether there was a subgroup of schizophrenic men who were more likely to have a low familial risk for schizophrenia or schizophrenia spectrum disorders, deficit symptoms, poor premorbid history, and birth in the winter months, suggesting possible early environmental insults, compared to schizophrenic women. Results showed that although men were more likely to meet these criteria, women also met them, thus suggesting gender differences in the prevalence of the subtype. Schizophrenic women were more likely to express a form of the illness characterized by dysphoria, persecutory delusions, and a higher family morbidity risk for schizophrenia than schizophrenic men. Results for spectrum disorders among relatives were equivocal with regard to gender.

摘要

以往的文献表明,精神分裂症男性和女性患不同亚型精神分裂症的风险可能不同。使用来自著名的回顾性队列家庭研究——爱荷华500和爱荷华非500的数据对这一假设进行了检验。样本包括171名男性和161名女性DSM-III精神分裂症患者及其713名一级亲属。首先,针对家庭发病率、发病年龄、病前史、出生季节以及缺陷和情感症状的表现进行了性别差异的双变量检验。然后,使用限制最大似然潜在类别分析来检验是否存在一个精神分裂症男性亚组,与精神分裂症女性相比,他们患精神分裂症或精神分裂症谱系障碍的家族风险较低、有缺陷症状、病前史不佳且在冬季出生,这表明可能存在早期环境损伤。结果显示,尽管男性更有可能符合这些标准,但女性也符合,因此表明该亚型在患病率上存在性别差异。与精神分裂症男性相比,精神分裂症女性更有可能表现出一种以烦躁不安、被害妄想以及精神分裂症家族发病风险较高为特征的疾病形式。亲属中谱系障碍的结果在性别方面不明确。

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