Munk-Jørgensen P, Mortensen P B
Institute of Psychiatric Demography, Aarhus Psychiatric Hospital, Risskov, Denmark.
Acta Psychiatr Scand. 1989 Apr;79(4):391-9. doi: 10.1111/j.1600-0447.1989.tb10275.x.
In Denmark about 11-12 per 100,000 population are diagnosed as schizophrenics for the first time each year. Less than half of these receive this diagnosis at first admission and therefore only 5-6 per 100,000 are included in the official schizophrenia incidence figures. In a cohort (n = 53), predictors for diagnosis of schizophrenia at the first admission were analysed (vs. first schizophrenia diagnosis only at a later admission). In accordance with the Danish concept of schizophrenia, affective flattening was found to have a significant correlation with the initial diagnosis of schizophrenia. Long duration of disease prior to the initial admission was also significantly correlated, indicating that a criterion of chronicity forms part of the Danish concept of schizophrenia. Schneider's first-rank symptoms also were more weakly correlated with the initial schizophrenia diagnosis. The probands were followed up personally and by case records (13 years). Good outcome was found in 23% of the probands and poor outcome in 50%. Affective flattening and Schneiderian first-rank symptoms at initial admission were correlated with poor outcome (NS). Schneiderian first-rank symptoms and social unease at initial admission were significantly correlated with schizophrenia as follow-up diagnosis. The initial clinical diagnosis of schizophrenia was not correlated with clinical outcome or with follow-up diagnosis.
在丹麦，每年每10万人口中约有11至12人首次被诊断为精神分裂症患者。其中不到一半的人在首次入院时就得到了这一诊断，因此官方统计的精神分裂症发病率数据中，每10万人中只有5至6人。在一个队列（n = 53）中，分析了首次入院时精神分裂症诊断的预测因素（与仅在后来入院时首次诊断为精神分裂症的情况进行对比）。根据丹麦对精神分裂症的定义，发现情感平淡与精神分裂症的初始诊断有显著相关性。首次入院前疾病持续时间长也有显著相关性，这表明慢性病程标准是丹麦精神分裂症定义的一部分。施奈德一级症状与精神分裂症初始诊断的相关性也较弱。对这些先证者进行了个人随访并查阅了病例记录（13年）。发现23%的先证者预后良好，50%的先证者预后不良。首次入院时的情感平淡和施奈德一级症状与预后不良相关（无统计学意义）。首次入院时的施奈德一级症状和社交不安与作为随访诊断的精神分裂症显著相关。精神分裂症的初始临床诊断与临床结局或随访诊断无关。
