Elaboration on premorbid intellectual performance in schizophrenia - Premorbid intellectual decline and risk for schizophrenia
Elaboration on premorbid intellectual performance in schizophrenia - Premorbid intellectual decline and risk for schizophrenia
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DOI：
10.1001/archpsyc.62.12.1297
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发表时间：
2005-12-01
影响因子：
--
通讯作者：
Davidson, M
中科院分区：
文献类型：
--
作者：
Reichenberg, A;Weiser, M;Davidson, M
背景：一致的证据表明，一些（但不是大多数）精神分裂症患者在出现精神病之前几年就智力低于平均水平。然而，尚不清楚这种低于平均水平的病前智力是稳定的还是渐进的。目的：研究精神分裂症风险的增加是否与从儿童期到青春期的智力表现下降有关。设计：在 8 至 17 年的随访期内，使用精神科住院治疗记录关联对整个人群进行历史队列研究。背景：由以色列征兵委员会进行强制评估。参与者：基于人群的队列研究555 326 名青少年出生于以色列。提供了 4 项智力分项测试以及阅读和拼写能力以及行为和心理社会变量的数据。采用基于回归的方法来评估 17 岁时的实际智商与基于阅读和拼写能力的儿童期估计智商之间的差异。主要结果指标：精神分裂症住院治疗（根据国际疾病统计分类第 10 次修订标准）。结果：17 岁时智商低于预期与以后住院治疗的风险增加相关。精神分裂症。在控制了潜在的混杂因素后得出结果。对于 75% 实际智商较低（= 85）的精神分裂症患者，实际智商比预期低 10 分或更多。低于预期的 10 与躁郁症、抑郁症或焦虑症无关。结论：间接证据表明，从儿童期到青春期的智力下降与精神分裂症风险增加有关。尽管病前智商得分在正常范围内，表面上健康的青少年后来表现出精神分裂症，但智力却下降了。
Context: Consistent evidence indicates that some, but not most, patients with schizophrenia have below-average intelligence years before they manifest psychosis. However, it is not clear whether this below-average premorbid intelligence is stable or progressive.Objective: To examine whether increased risk for schizophrenia is associated with declining intellectual performance from childhood through adolescence.Design: Historical cohort study of an entire population using record linkage for psychiatric hospitalization during an 8- to 17-year follow-up period.Setting: Mandatory assessment by the draft board of Israeli conscripts.Participants: Population-based cohort of 555 326 adolescents born in Israel. Data were available on 4 intelligence subtests as well as on reading and spelling abilities and on behavioral and psychosocial variables. A regression-based approach was used to assess the discrepancy between actual IQ at age 17 years and estimated IQ during childhood based on reading and spelling abilities.Main Outcome Measures: Hospitaltzation for schizophrenia (as per the International Statistical Classification of Diseases, 10th Revision criteria).Results: Lower-than-expected IQ at age 17 years was associated with increased risk for later hospitalization for schizophrenia. Results were held after controlling for potential confounders. For 75% of patients with schizophrenia with low actual IQ (= 85), actual IQ was 10 or more points lower than expected. Lower-than-expected 10 was not associated with bipolar disorder or with depression or anxiety disorder.Conclusions: Indirect evidence suggests that intellectual deterioration from childhood through adolescence is associated with increased risk for schizophrenia. Despite within-normal-range premorbid IQ scores, apparently healthy adolescents who will later manifest schizophrenia nevertheless have intellectual decline.