Agnew-Blais Jessica C, Buka Stephen L, Fitzmaurice Garrett M, Smoller Jordan W, Goldstein Jill M, Seidman Larry J
MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK;
Department of Epidemiology, Brown University, Providence, RI;
Schizophr Bull. 2015 Jul;41(4):817-23. doi: 10.1093/schbul/sbv027. Epub 2015 Apr 22.
Individuals who develop schizophrenia in adulthood exhibit, on average, deficits in childhood cognition relative to healthy controls. However, it remains unclear when in childhood such deficits emerge and whether they are stable across childhood or change (increase or decrease) across development. Importantly, whether the trajectory of childhood cognition differs among youth who later develop affective psychoses (AP) vs schizophrenia as adults remains unresolved. Subjects in the Collaborative Perinatal Project were administered the Stanford-Binet IQ test at age 4 and the Wechsler Intelligence Scale for Children at age 7. A total of 9809 (54.7%) participants in the New England Study sites were tested at both ages, including 37 who later developed schizophrenia spectrum psychoses (SSP) and 39 who later developed AP. Logistic regression models examined the association of level of and change in childhood IQ and later SSP or AP. Lower overall childhood IQ was associated with higher risk of SSP. Additionally, there was a small mean increase in IQ in the SSP group relative to a mean decrease in the control group from age 4 to 7 such that positive change in IQ was significantly associated with a higher risk of SSP. Neither overall level nor change in IQ was associated with risk of AP. The results are consistent with neurocognitive impairment throughout early childhood specifically for children who later develop schizophrenia, affirming the theory of atypical neurodevelopment in premorbid schizophrenia.
与健康对照组相比,成年后患上精神分裂症的个体在童年时期平均存在认知缺陷。然而,目前尚不清楚这些缺陷在童年的何时出现,以及它们在整个童年期是否稳定,还是会随着发育而变化(增加或减少)。重要的是,后来发展为情感性精神病(AP)的青少年与成年后患上精神分裂症的青少年在童年认知轨迹上是否存在差异仍未得到解决。协作围产期项目的受试者在4岁时接受了斯坦福-比奈智商测试,在7岁时接受了韦氏儿童智力量表测试。新英格兰研究地点共有9809名(54.7%)参与者在两个年龄段都接受了测试,其中包括37名后来发展为精神分裂症谱系精神病(SSP)的参与者和39名后来发展为AP的参与者。逻辑回归模型检验了童年智商水平和变化与后来的SSP或AP之间的关联。总体童年智商较低与患SSP的风险较高相关。此外,从4岁到7岁,SSP组的智商平均有小幅上升,而对照组的智商平均下降,因此智商的正向变化与患SSP的风险显著相关。智商的总体水平和变化均与患AP的风险无关。这些结果与整个幼儿期的神经认知障碍一致,特别是对于后来发展为精神分裂症的儿童,证实了病前精神分裂症的非典型神经发育理论。