Kendler K S, Thacker L, Walsh D
Dept. of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0710, USA.
Schizophr Bull. 1996;22(3):511-20. doi: 10.1093/schbul/22.3.511.
While structured psychiatric interviews have generally succeeded in identifying higher rates of schizotypal personality disorder in relatives of schizophrenia versus control probands, self-report questionnaires designed to assess schizotypy have been less successful at distinguishing these groups of relatives. In the Roscommon Family Study, an epidemiologically based, case-controlled study conducted in the west of Ireland, relatives were administered a short form of Eysenck's Psychoticism scale and shortened and modified versions of the scales for magical ideation and social anhedonia developed by Chapman and colleagues. We compared, with relatives of matched controls, relatives of four proband groups: schizophrenia, other nonaffective psychoses (ONAP), psychotic affective illness (PAI), and nonpsychotic affective illness (NPAI). Only social anhedonia scores successfully differentiated, at modest levels of significance, relatives of schizophrenia versus control probands. Levels of magical ideation did not distinguish relatives of schizophrenia, ONAP, PAI, or NPAI probands from relatives of controls. Compared to controls, ONAP probands had significantly elevated psychoticism scores, but no such increase was seen in relatives of schizophrenia, PAI, or NPAI probands. Dimensions of schizotypy assessed at personal interview were significantly better at differentiating relatives of schizophrenia and control probands than our measures of social anhedonia, magical ideation, or psychoticism. Although psychiatric interviews in this sample have shown that clinically assessed schizotypal personality disorder and traits strongly aggregate in relatives of schizophrenia patients, of the three self-report instruments designed to assess schizotypy, only one even modestly identifies relatives of schizophrenia versus control probands. These results suggest that, compared with psychiatric interviews, self-report questionnaires are less successful at assessing underlying familial vulnerability to schizophrenia.
虽然结构化精神病学访谈通常成功地在精神分裂症患者亲属中识别出比对照先证者更高的分裂型人格障碍发生率，但旨在评估分裂型特质的自我报告问卷在区分这些亲属群体方面成效较差。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病例对照研究，研究人员让亲属填写了艾森克精神质量表的简版以及由查普曼等人编制的神奇观念量表和社交快感缺乏量表的缩短及修订版。我们将四个先证者组的亲属与匹配对照的亲属进行了比较：精神分裂症患者组、其他非情感性精神病患者组（ONAP）、伴有精神病性症状的情感障碍患者组（PAI）和非精神病性情感障碍患者组（NPAI）。只有社交快感缺乏得分成功地在一定显著水平上区分了精神分裂症患者的亲属与对照先证者的亲属。神奇观念水平未能区分精神分裂症、ONAP、PAI或NPAI先证者的亲属与对照亲属。与对照组相比，ONAP先证者的精神质得分显著升高，但在精神分裂症、PAI或NPAI先证者的亲属中未观察到这种升高。在个人访谈中评估的分裂型特质维度在区分精神分裂症患者的亲属与对照先证者方面，比我们对社交快感缺乏、神奇观念或精神质的测量方法效果要好得多。尽管该样本中的精神病学访谈表明，临床评估的分裂型人格障碍及特质在精神分裂症患者亲属中高度聚集，但在旨在评估分裂型特质的三种自我报告工具中，只有一种甚至只是在一定程度上识别出了精神分裂症患者的亲属与对照先证者。这些结果表明，与精神病学访谈相比，自我报告问卷在评估潜在的家族性精神分裂症易感性方面成效较差。
