Fulton M, Winokur G
Department of Psychiatry, University of Iowa, College of Medicine.
Am J Psychiatry. 1993 Sep;150(9):1363-7. doi: 10.1176/ajp.150.9.1363.
Family studies have demonstrated a higher rate of schizoid personality in the families of probands with schizophrenia and a higher rate of paranoid personality in the families of probands with delusional disorder. The authors sought to investigate the familial characteristics of probands with schizoid and paranoid personality disorders and to delineate the clinical characteristics of the two groups.
Records of 351 inpatients with discharge diagnoses that included the term "schizoid personality" or "paranoid personality" were examined to identify patients who met DSM-III-R criteria for schizoid personality disorder (N = 34) or paranoid personality disorder (N = 19). Comparisons were made between the two groups with respect to clinical symptoms, familial characteristics, and longitudinal course.
The authors found that probands with schizoid personality disorder were hospitalized at an earlier age than probands with paranoid personality disorder, had more intervention before the index admission, and had greater morbidity following the index admission. They also found that descriptors of the two syndromes tended to congregate in the respective family material, but the differences were not statistically significant. Differences in the familial prevalence of schizophrenia were also not statistically significant.
These familial data do not support the hypothesis that schizophrenia congregates in the families of probands with schizoid personality disorder. Possible explanations for this finding are discussed.
家族研究表明,精神分裂症先证者的家族中分裂样人格障碍的发生率较高,而妄想性障碍先证者的家族中偏执型人格障碍的发生率较高。作者试图研究分裂样和偏执型人格障碍先证者的家族特征,并描述这两组的临床特征。
检查了351例出院诊断包含“分裂样人格”或“偏执型人格”的住院患者记录,以确定符合分裂样人格障碍(N = 34)或偏执型人格障碍(N = 19)的DSM-III-R标准的患者。对两组患者的临床症状、家族特征和病程进行了比较。
作者发现,分裂样人格障碍先证者的住院年龄比偏执型人格障碍先证者更早,在首次入院前接受的干预更多,并且在首次入院后的发病率更高。他们还发现,这两种综合征的描述词往往在各自的家族资料中聚集,但差异无统计学意义。精神分裂症家族患病率的差异也无统计学意义。
这些家族数据不支持精神分裂症聚集在分裂样人格障碍先证者家族中的假设。讨论了这一发现的可能解释。