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早发性和极早发性精神分裂症与成年发病精神分裂症的比较:法国 FACE-SZ 数据库。

Early and very early-onset schizophrenia compared with adult-onset schizophrenia: French FACE-SZ database.

机构信息

Fondation FondaMental, Créteil, France.

INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.

出版信息

Brain Behav. 2020 Feb;10(2):e01495. doi: 10.1002/brb3.1495. Epub 2020 Jan 7.

Abstract

OBJECTIVE

To compare the clinical symptomatology in patients with Early-Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551).

METHOD

In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset < 18 years (including 22 VEOS < 13 years).

RESULTS

The importance of better diagnosing EOS group, and in particularly VEOS, appeared in a longer DUP Duration of Untreated Psychosis (respectively, 2.6 years ± 4.1 and 8.1 years ± 5.7 vs. 1.0 years ± 2.5), more severe symptomatology (PANSS Positive And Negative Syndrome Scale scores), and lower educational level than the AOS group. In addition, the VEOS subgroup had a more frequent childhood history of learning disabilities and lower prevalence of right-handedness quotient than the AOS.

CONCLUSION

The study demonstrates the existence of an increased gradient of clinical severity from AOS to VEOS. In order to improve the prognosis of the early forms of schizophrenia and to reduce the DUP, clinicians need to pay attention to the prodromal manifestations of the disease.

摘要

目的

比较早发性精神分裂症(EOS,N=176)患者的临床症状,特别是非常早发性精神分裂症(VEOS)和成年起病精神分裂症(AOS,N=551)亚组。

方法

在一项大型法国多中心样本中,根据疾病发病年龄对 727 例稳定精神分裂症患者进行了评估,使用了标准化和广泛的临床和神经心理学量表:发病年龄≥18 岁的 AOS 和发病年龄<18 岁的 EOS(包括 22 例<13 岁的 VEOS)。

结果

EOS 组,特别是 VEOS 组,诊断更为重要,其未治疗精神病持续时间(分别为 2.6 岁±4.1 岁和 8.1 岁±5.7 岁与 1.0 岁±2.5 岁)更长,症状更为严重(阳性和阴性综合征量表评分),教育程度更低,与 AOS 组相比。此外,VEOS 亚组比 AOS 组更常出现儿童期学习障碍史和较低的右利手指数。

结论

该研究表明,从 AOS 到 VEOS 存在临床严重程度逐渐增加的梯度。为了改善早期精神分裂症的预后并缩短未治疗期,临床医生需要注意疾病的前驱症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1c/7010576/f7aa0b2ac295/BRB3-10-e01495-g001.jpg

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