McCreadie R G, Connolly M A, Williamson D J, Athawes R W, Tilak-Singh D
Crichton Royal Hospital, Dumfries.
Br J Psychiatry. 1994 Sep;165(3):340-6. doi: 10.1192/bjp.165.3.340.
The aim was to examine in a population of schizophrenic patients the clinical correlates of 'neurodevelopmental' schizophrenia and their relationship to putative aetiological factors.
Premorbid social adjustment, premorbid schizoid and schizotypal personality traits, and the obstetric history of 40 schizophrenic patients and their 102 sibs were assessed through interviews with their mothers. Patients' premorbid level of intelligence was assessed by the National Adult Reading Test and current symptoms by the Positive and Negative Syndrome Scale and the Subjective Deficit Syndrome Scale.
Patients had more schizoid and schizotypal traits than their sibs. They showed a deterioration in social adjustment between childhood and adolescence; sibs' social adjustment improved. There were statistically significant associations between current negative schizophrenic symptoms, premorbid deterioration in social adjustment, and schizoid and schizotypal personality traits, and between an early age of onset of illness and the same premorbid assessments. There was no evidence that patients with a family history of severe mental illness leading to hospitalisation, or a history of definite obstetric complications, had poorer premorbid functioning or more severe current symptoms.
We have confirmed clinical correlates of 'neurodevelopmental' schizophrenia but found no association between these and obstetric complications or a family history of severe mental disorder.
目的是在一组精神分裂症患者中研究“神经发育性”精神分裂症的临床相关因素及其与假定病因的关系。
通过与40名精神分裂症患者及其102名同胞的母亲进行访谈,评估病前社会适应、病前分裂样和分裂型人格特质以及产科病史。患者的病前智力水平通过国家成人阅读测试进行评估,当前症状通过阳性和阴性症状量表以及主观缺陷综合征量表进行评估。
患者比其同胞具有更多的分裂样和分裂型特质。他们在童年和青春期之间社会适应能力下降;同胞的社会适应能力有所改善。当前精神分裂症阴性症状、病前社会适应能力下降以及分裂样和分裂型人格特质之间存在统计学上的显著关联,并且发病年龄早与相同的病前评估之间也存在关联。没有证据表明有导致住院的严重精神疾病家族史或明确产科并发症史的患者病前功能较差或当前症状更严重。
我们证实了“神经发育性”精神分裂症的临床相关因素,但未发现这些因素与产科并发症或严重精神障碍家族史之间存在关联。