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精神病中的轻微身体异常:与临床及假定病因学变量的关联

Minor physical anomalies in psychoses: associations with clinical and putative aetiological variables.

作者信息

McGrath J J, van Os J, Hoyos C, Jones P B, Harvey I, Murray R M

机构信息

Clinical Studies Unit, Wolston Park Hospital, Wacol, Australia.

出版信息

Schizophr Res. 1995 Dec;18(1):9-20. doi: 10.1016/0920-9964(95)00016-x.

Abstract

This study of patients with functional psychoses set out to examine associations between minor physical anomalies (MPAs) and demographic, clinical, CT scan measures, and putative aetiological variables. 157 psychotic patients had minor physical anomalies assessed using a modified Waldrop scale. RDC diagnoses for these patients were: schizophrenia (n = 79), schizoaffective disorder (n = 31), mania (n = 24), major depression (n = 13), unspecified functional psychosis (n = 8), other organic psychosis (n = 2). 63 healthy white controls were also assessed with the modified Waldrop scale. Minor physical anomalies were not associated with any particular diagnosis. For white subjects, patients had significantly more MPAs than well controls. Anomalies of the palate were the most frequent item reported in patients and controls. For males, there was a weak association between the presence of MPAs and positive family history of a major psychiatric disorder. Those with MPAs required more frequent and longer psychiatric admissions, and showed impaired ability on a test sensitive to left parietal system function. Within the patient group, there were no associations between MPAs and gender, age at onset, negative symptoms, premorbid level of functioning, estimated premorbid intelligence, pregnancy and birth complications, and selected CT variables. Minor physical anomalies are found in a range of functional psychoses. There may be overlap between the various genes that predispose to psychiatric illness (especially in males) and those genes that predispose to developmental instability.

摘要

这项针对功能性精神病患者的研究旨在探讨轻微身体异常(MPA)与人口统计学、临床、CT扫描测量以及假定病因变量之间的关联。157名精神病患者使用改良的沃尔德罗普量表对轻微身体异常进行了评估。这些患者的研究诊断标准为:精神分裂症(n = 79)、分裂情感性障碍(n = 31)、躁狂症(n = 24)、重度抑郁症(n = 13)、未特定的功能性精神病(n = 8)、其他器质性精神病(n = 2)。63名健康白人对照也使用改良的沃尔德罗普量表进行了评估。轻微身体异常与任何特定诊断均无关联。对于白人受试者,患者的MPA明显多于健康对照。腭部异常是患者和对照中报告最多的项目。对于男性,MPA的存在与主要精神疾病的阳性家族史之间存在微弱关联。有MPA的患者需要更频繁、更长时间的精神科住院治疗,并且在一项对左顶叶系统功能敏感的测试中表现出能力受损。在患者组中,MPA与性别、起病年龄、阴性症状、病前功能水平、估计的病前智力、妊娠和分娩并发症以及选定的CT变量之间均无关联。在一系列功能性精神病中均发现了轻微身体异常。易患精神疾病的各种基因(尤其是男性)与易患发育不稳定的那些基因之间可能存在重叠。

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