Smith G N, Kopala L C, Lapointe J S, MacEwan G W, Altman S, Flynn S W, Schneider T, Falkai P, Honer W G
Department of Psychiatry and Radiology, University of British Columbia, Vancouver, Canada.
Psychol Med. 1998 May;28(3):645-53. doi: 10.1017/s0033291797006405.
Substantial variability in age at onset of illness and course of illness exists between patients with schizophrenia. Recent studies suggest that age at illness onset may be useful in defining biologically and clinically distinct subgroups of patients.
Two hundred and ten males with schizophrenia were classified as early-onset or adult-onset according to their age at first hospitalization. Birth history, clinical functioning and treatment response was assessed in a subgroup of patients. Brain anatomy was assessed from CT scans in all patients and in 32 non-psychiatric control subjects.
Patients with an early-onset were likely to have a history of obstetric complications, a poor response to neuroleptic treatment, and showed no relationship between ventricle size and duration of illness. Adult-onset patients were less likely to have obstetric complications, more likely to respond to treatment in the first years of illness, and showed an association between brain structure and duration of illness.
The distinction between early- and adult-onset patients may have important aetiological and treatment implications.
精神分裂症患者在发病年龄和病程方面存在显著差异。近期研究表明，发病年龄可能有助于界定生物学和临床上不同的患者亚组。
根据首次住院年龄，将210例男性精神分裂症患者分为早发型或成年型。对部分患者亚组评估其出生史、临床功能及治疗反应。对所有患者及32名非精神科对照受试者进行CT扫描以评估脑解剖结构。
早发型患者可能有产科并发症史，对抗精神病药物治疗反应较差，脑室大小与病程无关。成年型患者产科并发症较少，在发病头几年对治疗反应较好，脑结构与病程有关联。
早发型和成年型患者的区分可能对病因学和治疗具有重要意义。
