CHILDHOOD-ONSET SCHIZOPHRENIA - THE SEVERITY OF PREMORBID COURSE
CHILDHOOD-ONSET SCHIZOPHRENIA - THE SEVERITY OF PREMORBID COURSE
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DOI：
10.1097/00004583-199510000-00012
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发表时间：
1995-10-01
影响因子：
13.3
通讯作者：
RAPOPORT, JL
中科院分区：
文献类型：
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作者：
ALAGHBANDRAD, J;MCKENNA, K;RAPOPORT, JL
目的：回顾23例符合DSM-III-R精神分裂症诊断标准的12岁以前发病的儿童的病前病史，并与晚发精神分裂症儿童期资料进行比较。方法：根据医院和诊所记录、临床访谈、评定量表和测试对首次精神病症状出现前1年内的病前特征进行评定。结果如下：与以前的研究一致，自闭症的特定发育障碍和短暂的早期症状，特别是运动刻板印象，很常见。与儿童期相比，晚发性精神分裂症患者的语言发育延迟更大，病前言语和语言障碍、学习障碍和破坏性行为障碍更多。（60%的人接受过或估计符合一项或多项临床诊断的标准。结论：儿童期发作的精神分裂症可能代表了一种更恶性的疾病形式，尽管不能排除选择和确定偏倚。精神病前期语言障碍的存在使人们关注早期颞叶和额叶发育的重要性;早期短暂性运动刻板症提示基底神经节发育异常，并延长了晚发型患者儿童期的既往研究结果。
Objective: To review the premorbid histories of 23 children meeting DSM-III-R criteria for schizophrenia with onset before age 12 years and to compare these with childhood data of later-onset schizophrenics. Method: Premorbid features up to 1 year before onset of first psychotic symptoms were rated from hospital and clinic records, clinical interviews, rating scales, and tests. Results: In keeping with previous studies, specific developmental disabilities and transient early symptoms of autism, particularly motor stereotypies, were common. Comparison with the childhood of later-onset schizophrenics showed greater delay in language development, and more premorbid speech and language disorders, learning disorders, and disruptive behavior disorders. (Sixty percent had received or were estimated to meet criteria for one or more clinical diagnoses.) Conclusions: Childhood-onset schizophrenia may represent a more malignant form of the disorder, although selection and ascertainment bias cannot be ruled out. The presence of prepsychotic language difficulties focuses attention on the importance of early temporal and frontal lobe development; early transient motor stereotypies suggest developmental basal ganglia abnormalities and extend previous findings seen in the childhood of later-onset patients.