Immonen Johanna, Jääskeläinen Erika, Korpela Hanna, Miettunen Jouko
Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Early Interv Psychiatry. 2017 Dec;11(6):453-460. doi: 10.1111/eip.12412. Epub 2017 Apr 27.
The aim of this study was to analyse the effect of age at onset on the long-term clinical, social and global outcomes of schizophrenia through a systematic review and a meta-analysis. Original studies were searched from Web of Science, PsycINFO, Pubmed and Scopus, as well as manually. Naturalistic studies with at least a 2-year follow-up were included. Of the 3509 search results, 81 articles fulfilled the inclusion criteria. The meta-analysis was performed in Stata as a random-effect analysis with correlation coefficients between age at onset and the outcomes (categorized into remission, relapse, hospitalization, positive symptoms, negative symptoms, total symptoms, general clinical outcome, employment, social/occupational functioning and global outcome). There was a statistically significant (P < .05) correlation between younger age at onset and more hospitalizations (number of studies, n = 9; correlation, r = 0.17; 95% confidence interval, CI 0.09-0.25), more negative symptoms (n = 7; r = 0.14; 95% CI 0.01-0.27), more relapses (n = 3; r = 0.11; 95% CI 0.02-0.20), poorer social/occupational functioning (n = 12; r = 0.15; 95% CI 0.05-0.25) and poorer global outcome (n = 13; r = 0.14; 95% CI 0.07-0.22). Other relationships were not significant. This was the first systematic review of the effects of age at onset on the long-term outcomes of schizophrenia. The results show that age at onset has a small, but significant impact on some of the outcomes of schizophrenia.
本研究旨在通过系统评价和荟萃分析，分析起病年龄对精神分裂症长期临床、社会及整体结局的影响。从科学网、心理学文摘数据库、PubMed和Scopus以及手工检索原始研究。纳入至少随访2年的自然主义研究。在3509条检索结果中，有81篇文章符合纳入标准。在Stata中进行荟萃分析，作为随机效应分析，分析起病年龄与结局（分为缓解、复发、住院、阳性症状、阴性症状、总症状、一般临床结局、就业、社会/职业功能和整体结局）之间的相关系数。起病年龄较小与更多的住院次数（研究数量，n = 9；相关性，r = 0.17；95%置信区间，CI 0.09 - 0.25）、更多的阴性症状（n = 7；r = 0.14；95% CI 0.01 - 0.27）、更多的复发次数（n = 3；r = 0.11；95% CI 0.02 - 0.20）、较差的社会/职业功能（n = 12；r = 0.15；95% CI 0.05 - 0.25）和较差的整体结局（n = 13；r = 0.14；95% CI 0.07 - 0.22）之间存在统计学显著（P < 0.05）相关性。其他关系不显著。这是首次对起病年龄对精神分裂症长期结局影响的系统评价。结果表明，起病年龄对精神分裂症的某些结局有微小但显著的影响。
