Güleç Hüseyin, Ulusoy Kaymak Semra, Bilici Mustafa, Gangal Ali, Kayikç Ioğlu Temel, Sari Ahmet, Tan Üner
Karadeniz Technical University Medical Faculty, Department of Psychiatry Clinic, Trabzon, Turkey; Erenköy Education and Research Hospital, Department of Psychiatry Clinic, Istanbul, Turkey.
Ankara Oncology Education and Research Hospital, Department of Psychiatry Clinic, Ankara, Turkey.
Noro Psikiyatr Ars. 2013 Sep;50(3):256-262. doi: 10.4274/npa.y6504. Epub 2013 Sep 1.
A century ago, Kraepelin stated that the distinctive feature of schizophrenia was progressive deterioration. Kraepelin criteria for schizophrenia are: (1) continuous hospitalization or complete dependence on others for obtaining basic necessities of life, (2) unemployment and (3) no remission for the past five years. We aimed to determine the clinical appearance and structural biological features of Kraepelinian schizophrenia.
The sample consisted of 17 Kraepelinian patients, 30 non-Kraepelinian schizophrenic patients and 43 healthy controls. The Clinical Global Impressions (CGI) and the Positive and Negative Syndrome Scales (PANSS) were used for clinical assessment. The Frontal Assessment Battery (FAB) and the Verbal Fluency and Color Trail Test (CTT) were included in the cognitive battery. Brain magnetic resonance imaging and dermatoglyphic measurements were performed for structural features.
Duration of illness, hospitalization, suicide attempts, admission type, presence of a stressor and treatment choice were similar between the two patient groups. Treatment resistance and family history of schizophrenia were more common in Kraepelinian patients. PANSS and CGI subscales scores were also higher in this group. Only the category fluency and CTT-I were different in Kraepelinian patients in comparison to the other patient group. Structural findings were not different between the three groups.
Category fluency, which was lower in Kraepelinian patients, is an important marker of a degenerative process. The collection of severe clinical symptoms, family history of psychiatric illness and nonresponse to treatment in this particular group of patients points to the need to conduct further studies including cluster analysis in methodology.
一个世纪前，克雷佩林指出精神分裂症的显著特征是进行性衰退。克雷佩林精神分裂症的标准为：（1）持续住院或在获取基本生活必需品方面完全依赖他人，（2）失业，以及（3）过去五年未缓解。我们旨在确定克雷佩林型精神分裂症的临床表现和结构生物学特征。
样本包括17例克雷佩林型患者、30例非克雷佩林型精神分裂症患者和43名健康对照者。使用临床总体印象量表（CGI）和阳性与阴性症状量表（PANSS）进行临床评估。认知评估包括额叶评估量表（FAB）以及语言流畅性和色词测验（CTT）。进行脑磁共振成像和皮纹测量以评估结构特征。
两组患者在病程、住院情况、自杀未遂、入院类型、应激源的存在以及治疗选择方面相似。克雷佩林型患者中治疗抵抗和精神分裂症家族史更为常见。该组的PANSS和CGI分量表得分也更高。与另一组患者相比, 克雷佩林型患者仅在类别流畅性和CTT - I方面存在差异。三组之间的结构检查结果无差异。
克雷佩林型患者中较低的类别流畅性是退化过程的一个重要标志。这一特定患者群体中严重临床症状的聚集、精神疾病家族史以及对治疗无反应表明有必要在方法学上开展包括聚类分析在内的进一步研究。
