Kendler K S, McGuire M, Gruenberg A M, Walsh D
Department of Psychiatry and Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, USA.
Arch Gen Psychiatry. 1995 Apr;52(4):296-303. doi: 10.1001/archpsyc.1995.03950160046009.
Although schizotypal personality disorder aggregates in relatives of schizophrenic probands, the criteria for this disorder may not be optimal either in describing the dimensions of schizotypal phenomena or in identifying those with a high familial liability to schizophrenia.
In the Roscommon Family Study, an epidemiologically based family study of major psychiatric disorders conducted in the west of Ireland, we examined 25 individual schizotypal symptoms and signs, assessed by structured personal interview, in 1544 first-degree relatives (without chronic psychosis or mental retardation) of five proband groups: schizophrenia; other nonaffective psychoses; psychotic affective illness; nonpsychotic affective illness; and matched, unscreened controls.
We obtained seven meaningful schizotypal factors: negative schizotypy, positive schizotypy, borderline symptoms, social dysfunction, avoidant symptoms, odd speech, and suspicious behavior. Taken individually, all of these factors, except borderline symptoms, significantly discriminated relatives of schizophrenic probands from relatives of controls; in descending order of the odds ratios, they were odd speech, social dysfunction, suspicious behavior, negative schizotypy, avoidant symptoms, and positive schizotypy. In a multivariate analysis, four of these factors remained significant: odd speech, negative symptoms, social dysfunction, and avoidant symptoms. These schizotypal factors differed in their specificity. Three of the four most predictive schizotypal factors also significantly discriminated relatives of probands with other nonaffective psychoses from relatives of controls.
"Schizotypy" is a complex, multidimensional clinical construct, whose various dimensions differ widely both in the degree and specificity with which they reflect the familial liability to schizophrenia. Subpsychotic thought disorder; negative schizotypal signs, such as poor rapport and odd behavior; deficient occupational functioning; and social isolation/avoidance best characterized relatives of schizophrenic probands compared with relatives of matched controls.
尽管分裂型人格障碍在精神分裂症先证者的亲属中聚集，但该障碍的诊断标准在描述分裂型现象的维度或识别具有精神分裂症高家族易感性的个体方面可能并非最佳。
在罗斯康芒家族研究中，这是一项在爱尔兰西部进行的基于流行病学的主要精神障碍家族研究，我们通过结构化个人访谈评估了25种个体分裂型症状和体征，这些症状和体征来自五个先证者组的1544名一级亲属（无慢性精神病或智力障碍）：精神分裂症；其他非情感性精神病；伴有精神病性症状的情感障碍；非精神病性情感障碍；以及匹配的未筛查对照。
我们获得了七个有意义的分裂型因素：阴性分裂型、阳性分裂型、边缘症状、社会功能障碍、回避症状、言语怪异和可疑行为。单独来看，除边缘症状外，所有这些因素都能显著区分精神分裂症先证者的亲属与对照亲属；按优势比降序排列，它们依次为言语怪异、社会功能障碍、可疑行为、阴性分裂型、回避症状和阳性分裂型。在多变量分析中，其中四个因素仍然显著：言语怪异、阴性症状、社会功能障碍和回避症状。这些分裂型因素在特异性方面存在差异。四个最具预测性的分裂型因素中的三个也能显著区分其他非情感性精神病先证者的亲属与对照亲属。
“分裂型特质”是一个复杂的、多维度的临床概念，其各个维度在反映精神分裂症家族易感性的程度和特异性方面差异很大。与匹配对照的亲属相比，亚精神病性思维障碍；阴性分裂型体征，如关系不协调和行为怪异；职业功能缺陷；以及社会隔离/回避最能表征精神分裂症先证者的亲属。
