Age at onset and gender of schizophrenic patients in relation to neuroleptic resistance.
Age at onset and gender of schizophrenic patients in relation to neuroleptic resistance.
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DOI：
10.1176/ajp.154.4.475
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
H. Meltzer;H. Meltzer;J. Rabinowitz;M. Lee;P. Cola;Rakesh Ranjan;R. Findling;Paul Thompson
中科院分区：
文献类型：
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作者：
H. Meltzer;H. Meltzer;J. Rabinowitz;M. Lee;P. Cola;Rakesh Ranjan;R. Findling;Paul Thompson
目的男性精神分裂症的发病年龄通常(但并非总是)小于女性。早期发病也与抗精神病药治疗的不良反应和较差的长期结果有关。作者比较了抗精神病药物抵抗和反应性精神分裂症患者的发病年龄，以确定发病年龄的性别差异是否与抗精神病药物治疗的反应有关。方法322例精神分裂症或分裂情感性精神障碍患者为大学医院研究项目连续收治的患者。结果方差分析显示起病年龄与性别和对抗精神病药物的长期反应均有显著关系。抗精神病药敏感男性(平均21.2岁，SD=6.1，N=75)、抗精神病药物抵抗男性(平均19.4岁，SD=4.7，N=119)和抗精神病药物抵抗女性(平均20.1岁，SD=6.3，N=77)的平均发病年龄相似，而抗精神病药敏感女性的平均发病年龄(平均=24.2岁，SD=8.7，N=51)显著高于其他所有组。一个简单的效应模型表明，男性和女性抗精神病药物抵抗患者的平均发病年龄没有显著差异，而男性和女性抗精神病药物敏感患者的平均年龄有显著差异。性别和抗精神病药反应性对发病年龄的影响与精神分裂症亚型有关。结论这些结果证实了先前的数据，即抗精神病药抵抗与早期发病有关。在抗精神病药物抵抗患者中，男性和女性之间的发病年龄差异小于对抗精神病药物有反应的患者，这一发现表明，抗精神病药物患者在发病前和发病后都有所不同。
OBJECTIVE The age at onset of schizophrenia for males has usually but not always been reported to be less than that for females. Early onset has also been associated with poor response to neuroleptic treatment and worse long-term outcome. The authors compared age at onset in neuroleptic-resistant and -responsive schizophrenic patients to determine whether the gender difference in age at onset is related to response to neuroleptic treatment. METHOD The subjects were 322 patients with schizophrenia or schizoaffective disorder who were consecutively admitted to a university hospital-based research program. RESULTS Analysis of variance showed significant relationship between age at onset and both gender and longterm responsivity to neuroleptic drugs. The mean ages at onset in the neuroleptic-responsive men (mean = 21.2 years, SD = 6.1, N = 75), neuroleptic-resistant men (mean = 19.4 years, SD = 4.7, N = 119), and neuroleptic-resistant women (mean = 20.1 years, SD = 6.3, N = 77) were fairly similar, whereas that of the neuroleptic-responsive women (mean = 24.2 years, SD = 8.7, N = 51) was significantly greater than for all other groups. A simple effects model indicated that male and female neuroleptic-resistant patients did not differ significantly in mean age at onset, whereas male and female neuroleptic-responsive patients did. The effect of gender and neuroleptic responsivity on age at onset was related to schizophrenic subtype. CONCLUSIONS These results confirm previous data indicating neuroleptic resistance is associated with early onset. The finding that the difference in age at onset between males and females is smaller in neuroleptic-resistant patients than in neuroleptic-responsive patients suggests that neuroleptic-resistant patients differ premorbidly as well as after onset of illness.