Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
Psychol Med. 2024 Jul;54(9):2144-2151. doi: 10.1017/S0033291724000230. Epub 2024 Feb 16.
The concept of schizotypal personality disorder (SPD) emerged from observations of personality characteristics common in relatives of schizophrenic patients. While often studied in family designs, few studies and none with genetic measures, have examined SPD in epidemiological samples.
We studied individuals born in Sweden 1940-2000 with an ICD-10 diagnosis of SPD with no prior schizophrenia (SZ) diagnosis ( = 2292). Demographic features, patterns of comorbidity, and Family Genetic Risk Scores (FGRS) were assessed from multiple Swedish registries. Prediction of progression to SZ was assessed by Cox models.
SPD was rare, with a prevalence of 0.044%, and had high levels of comorbidity with autism spectrum disorder (ASD), OCD, ADHD, and major depression (MD), and increased rates of being single, unemployed and in receipt of welfare. Affected individuals had elevated levels of FGRS for SZ (+0.42), ASD (+0.30), MD (+0.29), and ADHD (+0.20). Compared to cases of schizophrenia, they had significantly lower rates of FGRS, but significantly elevated rates of genetic risk for ASD, MD, and ADHD. Over a mean follow-up of 8.7 years, 14.6% of SPD cases received a first diagnosis of SZ, the risk for which was significantly increased by levels of FGRS, male sex, young age at SPD diagnosis and an in-patient SPD diagnosis and significantly decreased by comorbidity with MD, ASD, and ADHD.
Our results not only support the designation of SPD as a schizophrenia spectrum disorder but also suggest potentially important etiologic links between SPD and ASD and, to a lesser extent, ADHD, OCD, and MD.
精神分裂型人格障碍（SPD）的概念源于对精神分裂症患者亲属中常见人格特征的观察。虽然在家族设计中经常研究 SPD，但很少有研究（也没有遗传措施）在流行病学样本中研究 SPD。
我们研究了在瑞典出生于 1940 年至 2000 年的 ICD-10 诊断为 SPD 且无先前精神分裂症（SZ）诊断的个体（=2292）。从多个瑞典登记处评估人口统计学特征、共病模式和家族遗传风险评分（FGRS）。通过 Cox 模型评估向 SZ 进展的预测。
SPD 非常罕见，患病率为 0.044%，与自闭症谱系障碍（ASD）、强迫症（OCD）、注意力缺陷多动障碍（ADHD）和重度抑郁症（MD）共病率高，单身、失业和领取福利的比例增加。受影响的个体的 SZ、ASD、MD 和 ADHD 的 FGRS 水平升高（+0.42、+0.30、+0.29 和+0.20）。与精神分裂症病例相比，他们的 FGRS 水平明显较低，但 ASD、MD 和 ADHD 的遗传风险水平明显升高。在平均 8.7 年的随访中，14.6%的 SPD 病例首次诊断为 SZ，FGRS 水平、男性性别、SPD 诊断时的年龄较小、住院 SPD 诊断以及与 MD、ASD 和 ADHD 的共病显著增加了 SZ 的风险，而与 MD、ASD 和 ADHD 的共病显著降低了 SZ 的风险。
我们的研究结果不仅支持将 SPD 指定为精神分裂症谱系障碍，而且还表明 SPD 与 ASD 之间存在潜在的重要病因联系，在较小程度上还与 ADHD、强迫症和 MD 之间存在潜在的病因联系。
