Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S Nashville, TN 37212, United States.
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S Nashville, TN 37212, United States; Research Service, Tennessee Valley HealthCare System, US Department of Veterans Affairs, United States.
Psychiatry Res. 2019 May;275:196-203. doi: 10.1016/j.psychres.2019.03.016. Epub 2019 Mar 11.
Schizophrenia is conceptualized as a neurodevelopmental disorder and pre-morbid differences in social function and cognition have been well-established. Less is known about pre-morbid temperament and personality. Inhibited temperament-the predisposition to respond to novelty with wariness, fear, or caution-is a premorbid risk factor for anxiety, depression, and substance use but is understudied in schizophrenia. Participants were patients with schizophrenia spectrum disorders (n = 166) and healthy controls (n = 180). Patients completed measures of childhood inhibited temperament, clinical symptoms (anxiety, depression, PANSS factors), and quality of life. Patients had significantly higher levels of inhibited temperament relative to healthy controls. In patients with schizophrenia, higher inhibited temperament was significantly associated with co-morbid anxiety disorders, greater anxiety and depression symptoms, higher PANSS Distress scores, lower PANSS Excitement scores, and lower quality of life. The current findings replicate and extend previous research with a larger sample and are consistent with vulnerability in an affective path to psychosis. In schizophrenia, higher inhibited temperament was associated with a cluster of mood and anxiety symptoms. Inhibited temperament was not associated with psychosis symptoms. Patients with high inhibited temperament may especially benefit from treatments that specifically target anxiety and depression.
精神分裂症被认为是一种神经发育障碍，已经明确了发病前社会功能和认知的差异。发病前的气质和个性则知之甚少。抑制气质——对新奇事物产生警惕、恐惧或谨慎的倾向——是焦虑、抑郁和物质使用的发病前危险因素，但在精神分裂症中研究较少。参与者为精神分裂症谱系障碍患者（n=166）和健康对照组（n=180）。患者完成了儿童期抑制气质、临床症状（焦虑、抑郁、PANSS 因子）和生活质量的测量。与健康对照组相比，患者的抑制气质水平明显更高。在精神分裂症患者中，较高的抑制气质与共病焦虑障碍、更高的焦虑和抑郁症状、更高的 PANSS 痛苦评分、更低的 PANSS 兴奋评分以及更低的生活质量显著相关。目前的研究结果在更大的样本中复制和扩展了之前的研究，与精神分裂症向精神病的情感途径中的易感性一致。在精神分裂症中，较高的抑制气质与一系列情绪和焦虑症状有关。抑制气质与精神病症状无关。抑制气质较高的患者可能特别受益于专门针对焦虑和抑郁的治疗。
