A prospective cohort study of childhood behavioral deviance and language abnormalities as predictors of adult schizophrenia
A prospective cohort study of childhood behavioral deviance and language abnormalities as predictors of adult schizophrenia
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DOI：
10.1093/oxfordjournals.schbul.a033461
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发表时间：
2000-01-01
影响因子：
6.6
通讯作者：
Cannon, TD
中科院分区：
文献类型：
--
作者：
Bearden, CE;Rosso, IM;Cannon, TD
学龄前精神分裂症个体的早期儿童语言和行为异常表明易患精神分裂症的病理过程从生命早期就存在。然而，这些损伤的病因学前因，以及它们预测成人精神分裂症的程度，尚未得到最终证明。为了解决这个问题，我在一个人群队列（72名患有精神分裂症或分裂情感性障碍的个体，63名未受影响的兄弟姐妹，以及7,941名未被诊断的个体）中检查了成人精神病学结果的语言和行为预测因素，并在8个月、4岁和7岁时进行了行为检查和言语和语言评估。通过成人治疗接触确定精神结局，并根据DSM-IV标准通过图表复习进行诊断。发现7岁时的社会适应不良可以预测成人精神分裂症，4岁和7岁时的局灶性越轨行为（如模仿、无意义的笑）与精神分裂症和兄弟姐妹状态显著相关。7岁时难以理解的言语是成人精神分裂症的高度显著预测因子（优势比= 12.7），而语言表达能力差预测精神分裂症和未受影响的兄弟姐妹的结局。早期行为和语言功能障碍与胎儿缺氧史或首次接触治疗年龄较早的精神分裂症前受试者的特征没有差异。考虑到未受影响的兄弟姐妹表现出类似的异常迹象，这些问题可能表明对这种疾病的基因型易感性，或共同的环境影响，或两者兼而有之。
Language and behavioral deviance in early childhood in preschizophrenia individuals suggests that the pathologic processes predisposing to schizophrenia are present from early in life. However, the etiologic antecedents of such impairments, and the degree to which they predict adult schizophrenia, have not been conclusively demonstrated. To address this, me examined language and behavioral predictors of adult psychiatric outcome in a population cohort (72 individuals with schizophrenia or schizoaffective disorder, 63 of their unaffected siblings, and 7,941 with no diagnosis) evaluated prospectively with behavioral examinations and a speech and language evaluation at 8 months, 4 years, and 7 years of age. Psychiatric outcome was ascertained via adult treatment contacts, and diagnoses were made by chart review according to DSM-IV criteria. Social maladjustment at age 7 was found to predict adult schizophrenia, and focal deviant behaviors (e.g., echolalia, meaningless laughter) at ages 4 and 7 were significantly associated with both schizophrenia and sibling status. Unintelligible speech at age 7 was a highly significant predictor of adult schizophrenia (odds ratio = 12.7), and poor expressive language ability predicted both schizophrenia and unaffected sibling outcome. Early behavioral and language dysfunction did not differentially characterize preschizophrenia subjects with a history of fetal hypoxia or an early age of first treatment contact. Given that unaffected siblings show similar signs of deviance, such problems may indicate genotypic susceptibility to the disorder, or shared environmental influences, or both.