Gureje O, Bamidele R, Raji O
Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Am J Psychiatry. 1994 Mar;151(3):368-71. doi: 10.1176/ajp.151.3.368.
A number of reports have suggested that early brain trauma, especially obstetric complications, may be associated with schizophrenia. This observation seems at variance with the similar rates of schizophrenia reported for advanced and developing countries when viewed against the high rate of perinatal morbidity in developing countries. Using patients with mania as comparison subjects, the authors investigated the association of early brain trauma with schizophrenia in adult life among Nigerian patients.
The manic (N = 12) and schizophrenic (N = 26) groups, both diagnosed according to the Research Diagnostic Criteria, were compared in respect to the prevalence of events commonly regarded as definite obstetric complications and the prevalence of childhood brain injury for which hospitalization was required.
A history of early brain trauma was associated with an adult diagnosis of schizophrenia. Schizophrenic patients with a history of early brain trauma were more likely than those without early brain trauma to have shown poor scholastic performance in childhood. They also showed mixed cerebral laterality in adulthood.
Early brain trauma may be a specific risk factor for the later development of schizophrenia. Patients with such a history may evidence other features of neurodevelopmental deviance.
多项报告表明,早期脑损伤,尤其是产科并发症,可能与精神分裂症有关。然而,从发展中国家围产期发病率较高的角度来看,发达国家和发展中国家精神分裂症报告发病率相似,这一观察结果似乎与之矛盾。作者以躁狂症患者作为对照对象,调查了尼日利亚成年患者中早期脑损伤与精神分裂症之间的关联。
根据研究诊断标准诊断的躁狂症组(N = 12)和精神分裂症组(N = 26),就通常被视为明确产科并发症的事件发生率以及需要住院治疗的儿童脑损伤发生率进行了比较。
早期脑损伤史与成年期精神分裂症诊断相关。有早期脑损伤史的精神分裂症患者比无早期脑损伤史的患者在童年时学业成绩更差的可能性更大。他们在成年期还表现出大脑双侧化混合。
早期脑损伤可能是精神分裂症后期发展的一个特定危险因素。有此类病史的患者可能表现出神经发育异常的其他特征。