Parkinsonian motor impairment predicts personality domains related to genetic risk and treatment outcomes in schizophrenia.
Parkinsonian motor impairment predicts personality domains related to genetic risk and treatment outcomes in schizophrenia.
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帕金森病运动障碍可预测与精神分裂症遗传风险和治疗结果相关的人格领域。
DOI：
10.1038/npjschz.2016.36
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发表时间：
2017
影响因子：
5.4
通讯作者：
Zw
中科院分区：
文献类型：
--
作者：
Molina,JuanL;Calvó,María;Padilla,Eduardo;Balda,Mara;Alemán,GabrielaGonzález;Florenzano,NéstorV;Guerrero,Gonzalo;Kamis,Danielle;Rangeon,BeatrizMolina;Bourdieu,Mercedes;Strejilevich,SergioA;Conesa,HoracioA;Escobar,JavierI;Zw
确定精神分裂症的内表型是至关重要的，并对临床实践具有深远的意义。在这里，我们提出了一种创新的方法来澄清气质和性格偏差与精神分裂症风险相关的机制，并预测长期治疗结果。我们招募了61名患有慢性精神分裂症的抗精神病药物初治受试者，99名未受影响的亲属和68名来自中部安第斯山脉农村社区的健康对照。诊断与神经精神病学临床评估的时间表确定;帕金森运动障碍与统一帕金森病评定量表测量;中脑实质进行了评估与经颅超声;和人格特质进行了评估，使用气质和性格调查表。约40%的索引病例的10年结局数据可用。精神分裂症患者的伤害回避和自我超越（ST）较高，而奖励依赖（RD）、合作性（CO）和自我导向（SD）较低。未受影响的亲属有较高的ST和较低的CO和SD。校正年龄和性别后，帕金森病能可靠预测RD、CO和SD。未经治疗的精神病（DUP）的平均持续时间超过5年。此外，SD与随访时的DUP和抗精神病药物剂量相关。基线DUP与抗精神病药物剂量-年相关。此外，“爆炸性/边缘”，“有条不紊/强迫”，和“混乱/典型”的人格特征与精神分裂症的风险增加有关。帕金森综合征可预测精神分裂症的核心人格特征和治疗结果我们的研究表明，RD，CO和SD是疾病的内在表型，可能部分由多巴胺能功能介导。此外，SD是治疗过程和结果的重要决定因素。
Identifying endophenotypes of schizophrenia is of critical importance and has profound implications on clinical practice. Here we propose an innovative approach to clarify the mechanims through which temperament and character deviance relates to risk for schizophrenia and predict long-term treatment outcomes. We recruited 61 antipsychotic naïve subjects with chronic schizophrenia, 99 unaffected relatives, and 68 healthy controls from rural communities in the Central Andes. Diagnosis was ascertained with the Schedules of Clinical Assessment in Neuropsychiatry; parkinsonian motor impairment was measured with the Unified Parkinson’s Disease Rating Scale; mesencephalic parenchyma was evaluated with transcranial ultrasound; and personality traits were assessed using the Temperament and Character Inventory. Ten-year outcome data was available for~ 40% of the index cases. Patients with schizophrenia had higher harm avoidance and self-transcendence (ST), and lower reward dependence (RD), cooperativeness (CO), and self-directedness (SD). Unaffected relatives had higher ST and lower CO and SD. Parkinsonism reliably predicted RD, CO, and SD after correcting for age and sex. The average duration of untreated psychosis (DUP) was over 5 years. Further, SD was anticorrelated with DUP and antipsychotic dosing at follow-up. Baseline DUP was related to antipsychotic dose-years. Further,‘explosive/borderline’,‘methodical/obsessive’, and ‘disorganized/schizotypal’personality profiles were associated with increased risk of schizophrenia. Parkinsonism predicts core personality features and treatment outcomes in schizophrenia. Our study suggests that RD, CO, and SD are endophenotypes of the disease that may, in part, be mediated by dopaminergic function. Further, SD is an important determinant of treatment course and outcome.