Comparison of clinical characteristics and treatment efficacy in childhood-onset schizophrenia and adolescent-onset schizophrenia in mainland China: A retrospective study
Comparison of clinical characteristics and treatment efficacy in childhood-onset schizophrenia and adolescent-onset schizophrenia in mainland China: A retrospective study
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DOI：
10.1111/eip.13121
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发表时间：
2021-01-19
影响因子：
2
通讯作者：
Ke, Xiaoyan
中科院分区：
文献类型：
--
作者：
Cheng, Xin;Zhang, Huihui;Ke, Xiaoyan
目的：儿童期发作精神分裂症（COS）与成人期发作精神分裂症（AOS）的对照研究较少。方法：回顾性分析2012 - 2019年早发性精神分裂症（EOS）住院患者电子病历582例（其中COS 216例，AOS 366例），比较COS与AOS在临床表现和治疗效果上的差异，并进一步分析影响疗效的因素。采用阳性和阴性症状量表（PANSS）评定精神病性症状。结果：EOS平均发病年龄为12.87 ± 2.19岁。COS较AOS病程长、起病隐匿、妄想少、阴性症状重、行为怪异者，更好地诊断COS的重要性。此外，COS的幻视和冲动行为发生率高于AOS。住院后，COS组和AOS组精神病性症状改善率分别为38.3%和47.8%。两组疗效比较差异有统计学意义。结论：COS患者的阴性症状、怪异行为、幻视和冲动行为较AOS患者明显，治疗效果较差。阴性症状的严重程度和发病年龄似乎是最值得注意的疗效预测因素。这些发现强调了早期发现和早期干预的重要性。
Aim: The comparative study of childhood-onset schizophrenia (COS) and adolescent-onset schizophrenia (AOS) is scarce. This study aimed to examine the differences in clinical presentations and treatment efficacy between COS and AOS and further analyse the factors affecting the efficacy of early-onset schizophrenia (EOS).Methods: A total of 582 electronic medical records of inpatients with EOS (216 COS and 366 AOS inpatients) between 2012 and 2019 were retrospectively analysed. The positive and negative syndrome scale (PANSS) was used to assess psychotic symptoms. Logistic regression analysis was performed to analyse the predictors of efficacy.Results: The mean age of onset of EOS was 12.87 +/- 2.19 years. The importance of better diagnosing COS appeared in a longer illness course, more frequently insidious onset, less frequent delusions, more severe negative symptoms and bizarre behaviours than AOS. Besides, COS had more frequent visual hallucinations and impulsive behaviours than AOS. After hospitalization, the improvement rate of psychotic symptoms in COS and AOS were 38.3% and 47.8%, respectively. The difference of efficacy between the two groups was statistically significant. Days of hospitalization, age of onset, presence of flat affect, PANSS total and negative score at admission were predictors of treatment efficacy in EOS individuals.Conclusions: COS inpatients suffer more obvious negative symptoms, bizarre behaviours, visual hallucinations and impulsive behaviours and worse efficacy than AOS inpatients. The severity of negative symptoms and age of onset seem the most noteworthy predictors of efficacy. These findings highlight the importance of early detection and early intervention.