The Child Mental Health Research Center, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Department of Psychiatry, Nanjing Lishui Psychiatric Hospital, Nanjing, China.
Early Interv Psychiatry. 2021 Dec;15(6):1721-1729. doi: 10.1111/eip.13121. Epub 2021 Jan 19.
The comparative study of childhood-onset schizophrenia (COS) and adolescent-onset schizophrenia (AOS) is scarce. This study aimed to examine the differences in clinical presentations and treatment efficacy between COS and AOS and further analyse the factors affecting the efficacy of early-onset schizophrenia (EOS).
A total of 582 electronic medical records of inpatients with EOS (216 COS and 366 AOS inpatients) between 2012 and 2019 were retrospectively analysed. The positive and negative syndrome scale (PANSS) was used to assess psychotic symptoms. Logistic regression analysis was performed to analyse the predictors of efficacy.
The mean age of onset of EOS was 12.87 ± 2.19 years. The importance of better diagnosing COS appeared in a longer illness course, more frequently insidious onset, less frequent delusions, more severe negative symptoms and bizarre behaviours than AOS. Besides, COS had more frequent visual hallucinations and impulsive behaviours than AOS. After hospitalization, the improvement rate of psychotic symptoms in COS and AOS were 38.3% and 47.8%, respectively. The difference of efficacy between the two groups was statistically significant. Days of hospitalization, age of onset, presence of flat affect, PANSS total and negative score at admission were predictors of treatment efficacy in EOS individuals.
COS inpatients suffer more obvious negative symptoms, bizarre behaviours, visual hallucinations and impulsive behaviours and worse efficacy than AOS inpatients. The severity of negative symptoms and age of onset seem the most noteworthy predictors of efficacy. These findings highlight the importance of early detection and early intervention.
儿童期发病精神分裂症（COS）和青少年期发病精神分裂症（AOS）的比较研究较少。本研究旨在探讨 COS 和 AOS 患者在临床表现和治疗效果方面的差异，并进一步分析影响早发性精神分裂症（EOS）疗效的因素。
回顾性分析了 2012 年至 2019 年间 582 例 EOS 住院患者（216 例 COS 和 366 例 AOS 患者）的电子病历。采用阳性和阴性症状量表（PANSS）评估精神症状。采用逻辑回归分析分析疗效的预测因素。
EOS 的发病年龄平均为 12.87±2.19 岁。更好地诊断 COS 的重要性体现在更长的病程、更频繁的隐匿性发病、更少的妄想、更严重的阴性症状和奇异行为上，而不是 AOS。此外，COS 比 AOS 更频繁地出现幻视和冲动行为。住院后，COS 和 AOS 患者的精神病症状改善率分别为 38.3%和 47.8%，两组疗效差异有统计学意义。住院天数、发病年龄、情感平淡、入院时 PANSS 总分和阴性评分是 EOS 患者治疗效果的预测因素。
COS 住院患者比 AOS 住院患者表现出更明显的阴性症状、奇异行为、幻视和冲动行为，且疗效更差。阴性症状的严重程度和发病年龄似乎是疗效最值得关注的预测因素。这些发现强调了早期发现和早期干预的重要性。
