Asperger syndrome and schizophrenia: Nueurodevelopmental continuum or separated clinical entities?
Asperger syndrome and schizophrenia: Nueurodevelopmental continuum or separated clinical entities?
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DOI：
10.22365/jpsych.2017.282.175
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发表时间：
2017-04-01
期刊：
影响因子：
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通讯作者：
Lazaratou, H
中科院分区：
文献类型：
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作者：
Anomitri, Chr;Lazaratou, H
这篇文章概述了关于阿斯伯格综合症和精神分裂症的文献，旨在讨论它们的异同。Eugen Bleuler在一个世纪前将“精神分裂症”和“自闭症”联系在一起，他认为自闭症是精神分裂症患者的一种孤独形式，代表着对现实的逃避。从那时起，人们就对这两种情况之间的界限感到困惑。如今，从基因组学、神经发育、精神病学等不同角度的最新研究为这些疾病提供了新的信息。在极端情况下区分这两种障碍比较容易，但将两种障碍的较温和形式分离开来却极为困难。阿斯伯格综合症（AS）被认为是一种持续的、终生的疾病，具有很强的遗传性，从儿童早期开始就存在。它属于自闭症谱系障碍的范畴，通常在儿童时期被诊断出来。阿斯伯格综合症患者通常诊断较晚，或者被认为患有精神分裂症。误诊阿斯伯格综合症会阻碍有效治疗，从而造成严重问题。许多阿斯伯格综合症的临床特征也出现在精神分裂症中，如社交障碍、沟通障碍和兴趣限制。另一方面，一些临床特征可能有助于鉴别诊断，如发病年龄较小，广泛性发育障碍的家族史，语言使用的语用方面，缺乏想象力等。众所周知，阿斯伯格综合症的症状与精神分裂症的症状有一些重叠，但对这两种综合症之间的共病知之甚少。幼儿的自闭症谱系障碍是否会增加以后患精神分裂症和其他精神疾病的风险，这仍然是一个问题。这两种疾病都是神经发育起源，遗传因素突出。在这两种情况下，神经认知缺陷以及社会认知和社会功能缺陷都很明显。AS和精神分裂症之间的界限仍然不清楚，即使这种区分对于患者及其家属的适当治疗是必要的。为了撰写文献综述，使用了以下电子数据库：PubMed， Scopus, Psycinfo, Cochrane Library， Web of Science和谷歌Scholar。关键词：阿斯伯格综合症，精神分裂症，儿童和青少年，鉴别诊断，自闭症谱系障碍。
This article is an overview of the literature on Asperger's syndrome and schizophrenia and aim to discuss their similarities and differences. Eugen Bleuler who associated the terms "schizophrenia" and "autism" a century ago, viewed autism as a form of solitude of schizophrenic patients representing withdrawal from reality. Ever since, there has been confusion as to the boundaries between these conditions. Nowadays recent research, from a variety of perspectives-genomics, neurodevelopment, psychiatry, etc. has given new information on these conditions. It is easier to demarcate these two disorders at the extremes, but it is extremely difficult dissociating milder forms of both disorders. Asperger's syndrome (AS), is considered to be a continuous and lifelong disorder with strong heritability, present from early childhood. It is included within the category of autism spectrum disorders and it is usually diagnosed in childhood. Patients with Asperger syndrome are often diagnosed late or they are considered as having schizophrenia. Misdiagnosing Asperger syndrome creates severe problems by preventing effective therapy. A lot of clinical characteristics of Asperger's syndrome are also present in schizophrenia, such as impaired social interaction, disabilities in communication and restricted interests. On the other side some clinical features may facilitate the differential diagnosis, such as the younger age at onset, family history of pervasive developmental disorders, pragmatic aspects of language use, lack of imagination, ect. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. It is still a question whether autism spectrum disorders in young children can increase the risk for the development of schizophrenia and other psychotic disorders, later in life. Both disorders are of neurodevelopmental origin and genetic factors are prominent. In both neurocognitive deficits as well as deficits in social cognition and social functioning are marked. The boundaries between AS and schizophrenia are still not clear even if this distinction is necessary for the appropriate treatment of the patient and his family. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Asperger's syndrome, schizophrenia, children and adolescents, differential diagnosis, autism spectrum disorders.