Discipline of Psychiatry and Mental Health, University of New South Wales, Kensington, New South Wales, Australia.
Neuroscience Research Australia, Sydney, New South Wales, Australia.
Br J Clin Psychol. 2022 Sep;61(3):836-858. doi: 10.1111/bjc.12363. Epub 2022 Mar 1.
The detection of young people at high risk for psychotic disorders has been somewhat narrowly focused on overt symptom-based markers that reflect mild reality distortion (e.g., psychotic-like experiences), or prodromal syndromes that are proximal to psychosis onset. The concept of schizotypy represents a broader framework for investigating risk for schizophrenia (and other disorders) in childhood, before the onset of prodromal or overt symptoms. We sought to detect profiles of risk for psychosis (schizotypy) in a general population sample of 22,137 Australian children aged 11-12 years, and to determine early life risk factors associated with these profiles from data available in linked records (registers).
Fifty-nine self-reported items were used as indicators of schizotypy across six broad domains; z-scores for each domain were subjected to latent profile analyses (LPA). A series of multinomial logistic regressions was used to examine the association between resulting profile (class) membership and several childhood and parental risk factors, and the proportion of children with mental disorders among each schizotypy profile was examined.
The LPA revealed three person-centred profiles referred to as True Schizotypy (n = 1,323; 6.0%), Introverted Schizotypy (n = 4,473; 20.2%), and Affective Schizotypy (n = 4,261; 19.2%), as well as a group of children showing no risk (n = 12,080; 54.6%). Prior exposure to perinatal and familial adversities including childhood maltreatment, as well as poor early childhood development and academic functioning, was variously associated with all risk groups. There was a higher proportion of childhood mental disorder diagnoses among children in the True Schizotypy group, relative to other profiles.
Subtle differences in the pattern of exposures and antecedents among schizophrenia liability profiles in childhood may reflect distinct pathogenic pathways to psychotic or other mental illness.
Children aged 11-12 years report characteristics of schizotypy which can be classified into three distinct profiles that may represent different pathological processes towards later mental ill-health. Early life exposure to perinatal and familial adversities including childhood maltreatment, early childhood developmental vulnerability, and poor academic functioning predict membership in all three childhood schizotypy profiles. Latent liability for schizophrenia (and potentially other mental disorders) may be represented by different profiles of functioning observable in childhood.
对精神病高危青年的检测主要集中在明显的基于症状的标志物上，这些标志物反映了轻度的现实扭曲（如类精神病体验）或接近精神病发作的前驱综合征。精神分裂症素质代表了一个更广泛的框架，用于在前驱或明显症状出现之前，在儿童时期研究精神分裂症（和其他疾病）的风险。我们试图在一个由 22137 名 11-12 岁澳大利亚儿童组成的普通人群样本中发现精神病（精神分裂症素质）的风险特征，并从关联记录（登记册）中可用的数据确定与这些特征相关的早期生命风险因素。
使用 59 个自我报告项目作为六个广泛领域的精神分裂症素质指标；每个领域的 z 分数都进行潜在剖面分析（LPA）。一系列多项逻辑回归用于检验与结果特征（类别）成员相关的关联，以及几个儿童和父母风险因素，并且检查每个精神分裂症素质特征的儿童精神障碍比例。
LPA 显示了三个以个体为中心的特征，分别称为真性精神分裂症素质（n=1323；6.0%）、内向性精神分裂症素质（n=4473；20.2%）和情感性精神分裂症素质（n=4261；19.2%），以及一组无风险的儿童（n=12080；54.6%）。先前暴露于围产期和家庭逆境，包括儿童期虐待，以及早期儿童发育和学业功能不良，与所有风险群体都有不同的关联。与其他特征相比，真性精神分裂症素质组的儿童中有更高比例的儿童精神障碍诊断。
儿童期精神分裂症易感性特征中暴露和前因的细微差异可能反映了精神病或其他精神疾病的不同发病途径。
11-12 岁的儿童报告的精神分裂症素质特征可以分为三个不同的特征，这些特征可能代表了不同的病理过程导致以后的精神健康不良。围产期和家庭逆境的早期暴露，包括儿童期虐待、早期儿童发育脆弱性和学业功能不良，预测了所有三个儿童精神分裂症素质特征的成员。精神分裂症（和潜在的其他精神障碍）的潜在易感性可能表现为儿童时期可观察到的不同功能特征。
