Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA.
University of Calgary, Department of Psychiatry, Calgary, Alberta, Canada.
Psychiatry Res. 2014 Jan 30;215(1):52-60. doi: 10.1016/j.psychres.2013.10.006. Epub 2013 Oct 18.
This study evaluates premorbid social and academic functioning in clinical high-risk individuals as predictors of transition to schizophrenia versus another psychotic disorder. Participants were 54 individuals enrolled in phase one of the North American Prodrome Longitudinal Study who over two and a half years of follow-up met criteria for schizophrenia/schizophreniform disorder (n=28) or another psychotic disorder (n=26). Social and academic functioning in childhood, early adolescence, and late adolescence was assessed at baseline using the Cannon-Spoor Premorbid Adjustment Scale. Social maladjustment in late adolescence predicted significantly higher odds of transition to schizophrenia versus another psychotic disorder independent of childhood and early adolescent adjustment (OR=4.02) and conveyed unique risk over academic maladjustment (OR=5.64). Premorbid academic maladjustment was not associated with psychotic disorder diagnosis. Results support diagnostic specificity of premorbid social dysfunction to schizophrenia in clinical high-risk youth and underscore an important role for social maladjustment in the developmental pathology of schizophrenia and its prediction.
这项研究评估了临床高风险个体的发病前社会和学术功能，作为向精神分裂症或其他精神障碍转变的预测因素。参与者为参加北美前驱纵向研究一期的 54 名个体，在两年半的随访中，符合精神分裂症/分裂样障碍标准的有 28 人（n=28），符合其他精神障碍标准的有 26 人（n=26）。在基线时，使用 Cannon-Spoor 发病前适应量表评估了儿童期、青少年早期和青少年晚期的社会和学术功能。青少年晚期的社会适应不良显著预示着向精神分裂症转变的几率高于其他精神障碍（OR=4.02），且与学术适应不良相比具有独特的风险（OR=5.64）。发病前学术适应不良与精神障碍诊断无关。研究结果支持了发病前社会功能障碍对临床高风险青年精神分裂症的诊断特异性，并强调了社会适应不良在精神分裂症的发展病理学及其预测中的重要作用。
