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[儿童精神分裂症的五因素模型]

[The 5 factor model of childhood schizophrenia].

作者信息

Klapal M, Eggers C, Bunk D, Koriath H

机构信息

Klinik für Kinder- und Jugendpsychiatrie, Rheinische Landes- und Hochschulklinik, Essen.

出版信息

Nervenarzt. 1998 Mar;69(3):238-42. doi: 10.1007/s001150050265.

Abstract

Forty-four first-admission patients with childhood-onset schizophrenia (age at onset < or = 14 years) were examined retrospectively for 30 clinical symptoms using the Positive and Negative Syndrome Scale (PANSS; 15). A principal component analysis with varimax rotation was applied to the full item set of this scale and revealed five orthogonal independent symptom groups: cognition affect, social withdrawal, anti-social behavior, excitement, and reality distortion. In order to validate these psychopathological dimensions we analyzed the relation between the five factor scores and outcome variables (Disability Assessment Schedule, DAS-M; 13) several years after onset: Social withdrawal was correlated with poor outcome; reality distortion was related to good outcome (P < 0.01). A multivariate ANOVA identified group differences in the anti-social behavior factor between acute and insidious onset of illness and between boys and girls; patients with an acute onset scored significantly higher on the excitement factor than those with an insidious onset (P < 0.05). According to our results more than two dimensions are necessary to describe the psychopathology of childhood-onset schizophrenia, similar to adolescent- and adult-onset schizophrenia.

摘要

对44例首发的儿童期起病精神分裂症患者(起病年龄≤14岁)进行回顾性研究,使用阳性与阴性症状量表(PANSS;15项)评估30种临床症状。对该量表的全部项目集进行主成分分析并采用方差最大化旋转,结果显示五个正交独立的症状组:认知情感、社交退缩、反社会行为、兴奋和现实歪曲。为验证这些精神病理学维度,我们分析了起病数年之后五个因子得分与结局变量(残疾评定量表,DAS-M;13项)之间的关系:社交退缩与不良结局相关;现实歪曲与良好结局相关(P<0.01)。多因素方差分析确定了疾病急性起病与隐匿起病之间以及男孩与女孩之间在反社会行为因子上的组间差异;急性起病患者的兴奋因子得分显著高于隐匿起病患者(P<0.05)。根据我们的研究结果,描述儿童期起病精神分裂症的精神病理学需要两个以上维度,这与青少年期及成人期起病的精神分裂症相似。

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