Howard R, Castle D, Wessely S, Murray R
Section of Old Age Psychiatry, Institute of Psychiatry, Denmark Hill, London.
Br J Psychiatry. 1993 Sep;163:352-7. doi: 10.1192/bjp.163.3.352.
The presence or absence of 22 schizophrenic symptoms was recorded with the age at onset of illness in 470 patients with non-affective, non-organic psychoses. Positive and negative formal thought disorder, affective symptoms, inappropriate affect, delusions of grandiosity or passivity, primary delusions other than delusional perception, and thought insertion and withdrawal were all more common in early-onset cases (age at onset 44 years or less; n = 336). Persecutory delusions with and without hallucinations, organised delusions, and third-person, running commentary and accusatory or abusive auditory hallucinations were all more common in late-onset cases (age at onset 45 years or more; n = 134). There was no difference between cases of early and late onset in the prevalence of delusions of reference, bizarre delusions, delusional perception, or lack of insight. We conclude that although there are clinical similarities between cases of schizophrenia with early and late onset, there are sufficient differences between them to suggest that they are not phenotypically homogeneous.
记录了470例非情感性、非器质性精神病患者的22种精神分裂症症状的有无及发病年龄。阳性和阴性形式思维障碍、情感症状、情感不适当、夸大或被动妄想、除妄想性知觉外的原发性妄想以及思维插入和思维被夺在早发病例（发病年龄44岁及以下；n = 336）中更为常见。伴有或不伴有幻觉的被害妄想、系统性妄想以及第三人称、连续评论性和指责性或辱骂性幻听在晚发病例（发病年龄45岁及以上；n = 134）中更为常见。早发和晚发病例在牵连观念、怪异妄想、妄想性知觉或自知力缺乏的患病率上没有差异。我们得出结论，虽然早发和晚发精神分裂症病例之间存在临床相似性，但它们之间存在足够的差异，表明它们在表型上并非同质。
