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[儿童期起病的精神分裂症及病前孤独症症状患者的神经发育障碍、精神共病及相关病理情况。]

[Neurodevelopmental Disorders, Psychiatric Comorbidities and Associated Pathologies in Patients with Childhood-Onset Schizophrenia and Premorbid Autistic Symptoms.].

作者信息

Fernandez A, Pasquet-Levy M, Laure G, Thümmler S, Askenazy F

机构信息

Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice CHU-LENVAL, 57 avenue de la Californie, Nice, France.

Université Côte d'Azur, CoBTek, FRIS, Nice, France.

出版信息

Can J Psychiatry. 2021 Dec;66(12):1042-1050. doi: 10.1177/0706743721990822. Epub 2021 Feb 10.

DOI:10.1177/0706743721990822
PMID:33563032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8689449/
Abstract

INTRODUCTION

Childhood-Onset Schizophrenia (COS) is a rare (1/40000), severe and neurodevelopmental form of schizophrenia beginning before 13 years of age. Little is known about comorbidities and specific COS-related disorders. Thus, the objective of our study was to evaluate them from a psychiatric, neurodevelopmental and somatic perspective.

METHOD

This is an ancillary study of the GenAuDiss protocol. A standardized psychiatric interview (K-SADS-PL DSM5) and a neuropsychological assessment (WISC-V/WAIS-IV) were carried out in outpatients with COS as well as a medical history collection concerning pregnancy, perinatal period, development, biography and medical and psychiatric, personal, and family history.

RESULTS

20 outpatients were included. The mean age of onset of COS was 8.90 years (+/- 2.30). Psychiatric comorbidities (DSM5) were Attention Deficit Hyperactivity Disorder (15/20 patients), Anxiety Disorders (14/20) and Autism Spectrum Disorder (13/20). The average IQ was 70.26 (+/- 18.09). A language delay and a break in school career were noted in 18/20 patients. Finally, the main associated somatic disorder was asthma (15/20 patients).

DISCUSSION

We highlighted in our patients with COS a high frequency of comorbidities including at least one systematic psychiatric disorder. However, although COS is a severe condition impacting the patient, his family and society, its management remains essentially symptomatic. In clinical practice, it is necessary to look for all these comorbidities and to manage them in order to improve the overall quality of care.

摘要

引言

儿童期精神分裂症(COS)是一种罕见的(1/40000)、严重的神经发育型精神分裂症,起病于13岁之前。关于其合并症及特定的COS相关障碍知之甚少。因此,我们研究的目的是从精神、神经发育和躯体角度对它们进行评估。

方法

这是GenAuDiss方案的一项辅助研究。对COS门诊患者进行了标准化精神访谈(K-SADS-PL DSM5)和神经心理学评估(WISC-V/WAIS-IV),并收集了有关妊娠、围产期、发育、个人经历以及医学、精神、个人和家族史的病史。

结果

纳入了20名门诊患者。COS的平均起病年龄为8.90岁(±2.30)。精神合并症(DSM5)包括注意力缺陷多动障碍(15/20例患者)、焦虑症(14/20)和自闭症谱系障碍(13/20)。平均智商为70.26(±18.09)。18/20例患者存在语言发育迟缓及学业中断情况。最后,主要的相关躯体疾病是哮喘(15/20例患者)。

讨论

我们在COS患者中发现了高频率的合并症,包括至少一种系统性精神障碍。然而,尽管COS是一种影响患者及其家庭和社会的严重疾病,其治疗仍主要是对症治疗。在临床实践中,有必要查找所有这些合并症并进行管理,以提高整体护理质量。

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