Zhang Hong, Zhang Lin, Liu Zhihua, Ma Jun
Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China.
Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China.
Alpha Psychiatry. 2024 Sep 1;25(5):611-616. doi: 10.5152/alphapsychiatry.2024.241626. eCollection 2024 Sep.
A distinct subtype of schizophrenia (SCZ) is the one accompanied with autistic features (AF). This study aimed to determine the prevalence of AF in initial-treatment and drug-naive (ITDN) patients with SCZ and investigate its influencing factors.
The study recruited 710 ITDN patients with SCZ. Their sociodemographic data and general clinical information were collected, and a clinical psychological assessment was performed to quantify their psychopathology and disease severity. The severity of AF was calculated based on psychopathology scores.
Overall, 19.01% (135/710) patients with SCZ showed AF. Patients with AF exhibited higher levels of thyroid-stimulating hormone (TSH) ( = -4.54, < .001) and lower levels of free triiodothyronine (FT) and free tetraiodothyronine (FT) ( = 2.38, = .018; = 3.19, = .002) than those with AF. Binary logistic regression analysis revealed waist circumference ( = 0.03, = .022, odds ratio (OR) = 1.03) and TSH level ( = 0.54, < .001, OR = 1.71) as risk factors for AF, and deemed low-density lipoprotein cholesterol ( = -0.43, = .025, OR = 0.65), fasting blood glucose ( = -0.72, = .013, OR = 0.49), FT ( = -0.32, = .034, OR = 0.73), and FT ( = -0.08, = .025, OR = 0.93) levels as protective factors. Multiple linear regression analysis identified FT level ( = -0.85, = -2.22, = .028, 95%, Confidence Intervals (CI): -1.61- -0.09) as a protective factor influencing AF severity.
This study reports the prevalence of AF in the target SCZ population and identifies factors associated with its development and severity. The discernment of these distinctive clinical features may facilitate formulation of tailored prevention strategies and interventions for this precise subset of SCZ patients.
精神分裂症（SCZ）的一种独特亚型是伴有自闭症特征（AF）的类型。本研究旨在确定初治且未用过药（ITDN）的SCZ患者中AF的患病率，并调查其影响因素。
该研究招募了710例ITDN的SCZ患者。收集他们的社会人口学数据和一般临床信息，并进行临床心理评估以量化他们的精神病理学和疾病严重程度。基于精神病理学评分计算AF的严重程度。
总体而言，19.01%（135/710）的SCZ患者表现出AF。与无AF的患者相比，有AF的患者促甲状腺激素（TSH）水平更高（t = -4.54，P <.001），游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平更低（t = 2.38，P = .018；t = 3.19，P = .002）。二元逻辑回归分析显示腰围（β = 0.03，P = .022，比值比（OR）= 1.03）和TSH水平（β = 0.54，P <.001，OR = 1.71）是AF的危险因素，而低密度脂蛋白胆固醇（β = -0.43，P = .025，OR = 0.65）、空腹血糖（β = -0.72，P = .013，OR = 0.49）、FT3（β = -0.32，P = .034，OR = 0.73）和FT4（β = -0.08，P = .025，OR = 0.93）水平为保护因素。多元线性回归分析确定FT3水平（β = -0.85，t = -2.22，P = .028，95%置信区间（CI）：-1.61 - -0.09）是影响AF严重程度的保护因素。
本研究报告了目标SCZ人群中AF的患病率，并确定了与其发生和严重程度相关的因素。识别这些独特的临床特征可能有助于为这一特定亚组的SCZ患者制定量身定制的预防策略和干预措施。
