School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
J Psychiatr Ment Health Nurs. 2021 Dec;28(6):1092-1112. doi: 10.1111/jpm.12733. Epub 2021 Mar 15.
WHAT IS KNOWN ON THE SUBJECT?: The complexity and high prevalence of schizotypal personality disorders (SPD) pose serious challenges for mental health practice in its management, and also bring severe consequences for the patients. The identification of the specific early life factors (ELFs) that confer risk to SPD has become a major focus of clinical research on schizophrenia-spectrum disorders which aligns well with the mental health nursing's responsibility in health promotion, prevention and treatment. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Adolescents may experience certain ELFs, which contribute to the occurrence of SPD, but no systematic review has been conducted to identify ELF among them. And nursing literature addressing modifiable ELF is very limited. Two clusters of ELF and SPD in adolescents were identified: prenatal and early postnatal factors; childhood trauma and parental factors. The findings also show that more research is needed to determine the specificity and cumulative effects of ELF on the development of SPD by using rigorous and comprehensive measurements and a longitudinal design. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses, especially nurses in the primary care, should be aware of potentially modifiable ELFs and incorporate more comprehensive and valid instrument for assessing cumulative ELF and SPD. These findings may serve to inform possible future interventions for SPD, such as parent education and support to mitigate these risk factors.
INTRODUCTION: Schizotypal personality disorder (SPD) affects 4% of the general population in the United States. The identification of early life factors (ELFs) that confer risk to SPD in adolescents (ages 10-24 years old) has become a major focus of clinical research on schizophrenia-spectrum disorders.
This systematic review aims to determine what ELFs contribute to the onset of SPD in the adolescent population.
A systematic search of PubMed, PsycINFO, Psychiatry online, Scopus, Web of Science, EMBASE and CINAHL databases was conducted using relevant keywords. Data were extracted using a standardized form following PRISMA guidelines.
Twenty-four studies met the criteria for inclusion. ELFs in the development of SPD were grouped into two important clusters: (a) prenatal and early postnatal factors; (b) childhood trauma and parental factors.
Mental health nurses, especially nurses in primary care, should be aware of potentially modifiable ELF. Longitudinal research is needed to determine the causative roles of these ELF play in the occurrence of SPD by using rigorous measurements.
These findings call for awareness of the modifiable ELF for SPD and also inform possible future interventions to reduce these risks, such as parent-training or environmental enrichment programmes.
精神分裂型人格障碍（SPD）的复杂性和高患病率给精神卫生实践在其管理方面带来了严峻挑战，也给患者带来了严重后果。确定导致 SPD 的特定生命早期因素（ELF）已成为精神分裂症谱系障碍临床研究的主要焦点，这与精神健康护理在促进健康、预防和治疗方面的责任相一致。
青少年可能会经历某些导致 SPD 发生的 ELF，但目前尚无系统评价来确定其中的 ELF。而且，针对可改变的 ELF 的护理文献非常有限。本研究确定了青少年中 ELF 和 SPD 的两个聚类：产前和产后早期因素；儿童创伤和父母因素。研究结果还表明，需要使用严格和全面的测量方法和纵向设计，进一步研究 ELF 对 SPD 发展的特异性和累积效应。
精神健康护士，尤其是初级保健护士，应该意识到潜在的可改变的 ELF，并采用更全面和有效的工具来评估累积的 ELF 和 SPD。这些发现可能有助于为 SPD 提供未来可能的干预措施，例如父母教育和支持，以减轻这些风险因素。
