Remschmidt H, Schulz E, Martin M, Fleischhaker C, Trott G E
Klinik für Kinder- und Jugendpsychiatrie, Philipps-Universität Marburg.
Z Kinder Jugendpsychiatr. 1994 Dec;22(4):239-52.
Schizophrenic disorders in childhood are rare. Only about 0.5 to 1% of all such disorders have their onset before age 9 and about 4% before age 14. In puberty and early adolescence, however, there is a marked increase in the frequency of such disorders. In childhood more boys seem to be affected, but during adolescence this difference seems to disappear. Possible etiological factors currently under discussion are genetic factors, neurointegrative deficits, attentional deficits, communication deficits and conspicuous premorbid features. With regard to the latter, the authors could show that positive and negative symptoms appear months or even years before the first manifestation of the disorder requiring inpatient treatment. From this perspective schizophrenic disorders in general and those with early onset in particular fit a dimensional model of illness better than a categorical one. In the development of preventive measures more attention to premorbid features is essential.
儿童期精神分裂症较为罕见。在所有此类疾病中,仅有约0.5%至1%在9岁前发病,约4%在14岁前发病。然而,在青春期和青春早期,此类疾病的发病率显著上升。在儿童期,似乎男孩受影响更多,但在青春期这种差异似乎消失。目前正在讨论的可能病因包括遗传因素、神经整合缺陷、注意力缺陷、沟通缺陷以及明显的病前特征。关于后者,作者能够表明,阳性和阴性症状在需要住院治疗的疾病首次出现前数月甚至数年就已出现。从这个角度来看,一般的精神分裂症,尤其是早发性精神分裂症,更符合疾病的维度模型而非分类模型。在制定预防措施时,更多地关注病前特征至关重要。