一种针对早发性精神分裂症过渡模型的神经发育方法。

A Neurodevelopment Approach for a Transitional Model of Early Onset Schizophrenia.

作者信息

De Berardis Domenico, De Filippis Sergio, Masi Gabriele, Vicari Stefano, Zuddas Alessandro

机构信息

Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini," National Health Service (NHS), 64100 ASL 4 Teramo, Italy.

Department of Neurosciences and Imaging, University "G. D'Annunzio", 66100 Chieti, Italy.

出版信息

Brain Sci. 2021 Feb 23;11(2):275. doi: 10.3390/brainsci11020275.

Abstract

In the last decades, the conceptualization of schizophrenia has dramatically changed, moving from a neurodegenerative process occurring in early adult life to a neurodevelopmental disorder starting be-fore birth, showing a variety of premorbid and prodromal symptoms and, in relatively few cases, evolving in the full-blown psychotic syndrome. High rates of co-occurring different neurodevelopmental disorders such as Autism spectrum disorder and ADHD, predating the onset of SCZ, and neurobio-logical underpinning with significant similarities, support the notion of a pan-developmental disturbance consisting of impairments in neuromotor, receptive language, social and cognitive development. Con-sidering that many SCZ risk factors may be similar to symptoms of other neurodevelopmental psychi-atric disorders, transition processes from child & adolescent to adult systems of care should include both high risk people as well as subject with other neurodevelopmental psychiatric disorders with different levels of severity. This descriptive mini-review discuss the need of innovative clinical approaches, re-considering specific diagnostic categories, stimulating a careful analysis of risk factors and promoting the appropriate use of new and safer medications.

摘要

在过去几十年里,精神分裂症的概念发生了巨大变化,从成年早期发生的神经退行性过程转变为出生前就开始的神经发育障碍,表现出各种病前和前驱症状,在相对较少的病例中,发展为全面的精神病综合征。在精神分裂症发病之前,自闭症谱系障碍和注意力缺陷多动障碍等多种共病的神经发育障碍发生率很高,且神经生物学基础存在显著相似性,这支持了一种泛发育障碍的概念,即包括神经运动、接受性语言、社交和认知发育受损。鉴于许多精神分裂症风险因素可能与其他神经发育性精神障碍的症状相似,从儿童和青少年到成人护理系统的过渡过程应包括高危人群以及患有不同严重程度的其他神经发育性精神障碍的患者。这篇描述性的小型综述讨论了创新临床方法的必要性,重新考虑特定的诊断类别,促使对风险因素进行仔细分析,并促进新的、更安全药物的合理使用。

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