First-onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology.
First-onset schizophrenia in the community: relationship of urbanization with onset, early manifestations and typology.
复制标题
社区首发精神分裂症：城市化与发病、早期表现和类型的关系。
DOI：
10.1111/j.1600-0447.1997.tb09944.x
复制
发表时间：
1997
影响因子：
6.7
通讯作者：
Susser,ES
中科院分区：
文献类型：
--
作者：
Varma,VK;Wig,NN;Phookun,HR;Misra,AK;Khare,CB;Tripathi,BM;Behere,PB;Yoo,ES;Susser,ES
作为世界卫生组织在发展中国家和发达国家12个中心的协作研究的一部分，在确定的城市和农村集水区分别有348 786人和103 865人，通过对所有病例进行全面和积极的招募，在24个月期间分别确定了155例和54例首发精神分裂症病例。两个队列中大约50%的受试者年龄在15-24岁之间。在年轻年龄组中男性占多数，在老年组中女性占多数。大多数病例无家族史，在儿童期和青春期有良好的适应能力。与所有发达国家的数据相比，在我们的样本中和(在农村队列中更常见)，发病更频繁、更严重、更不隐蔽。关于这种疾病的早期表现，在我们的两个样本中，对外表和清洁失去兴趣、无缘无故易怒和愤怒、失去食欲、睡眠或性生活兴趣的发生率，以及在我们的农村队列中持续数天或数周的兴奋或过度活跃的发生率远远高于发达国家的整个中心。另一方面，在我们的农村群体中，声称不可能的事情，表现得好像听到声音，感觉受到迫害、伤害或迷惑的情况，比起城市群体或整个发达国家的中心要少得多。关于精神分裂症的临床诊断，偏执狂、青春期/精神错乱和残留型在我们的样本中的比例较低(在农村样本中比例更低)，而紧张型和急性精神分裂症发作的比例与发达国家中心相比偏高。此外，在我们的样本中，CATEGO班的受试者S+的比例较低。关于精神分裂症的发病、早期表现和临床亚型，我们的农村群体总体上偏离了发达国家的中心，我们的城市样本介于两者之间，因此表明社会文化因素，特别是城市化在精神分裂症这些变量中的作用。
As part of a World Health Organization collaborative study in 12 centres in developing and developed countries within defined urban and rural catchment areas with populations of 348 786 and 103 865, respectively, a total of 155 and 54 cases of first‐onset schizophrenia, respectively, were identified over a 24‐month period by a comprehensive and active recruitment of all cases. Approximately 50% of the subjects in both cohorts were in the age range of 15–24 years. There was a preponderance of males in the younger age group and of females in the older age group. The majority of cases had no family history and had shown good adjustment in childhood and adolescence. The onset was much more frequently acute and much less often insidious in our samples and (more so in the rural cohort), compared to the figure for all developed countries’ sites. With regard to early manifestations of the disorder, there was a much higher incidence of loss of interest in appearance and cleanliness, being irritable and angry without reason, and loss of appetite, sleep or interest in sex in both of our samples, and of being excited or overactive for days or weeks in our rural cohort than in the developed countries’ centres as a whole. On the other hand, claiming impossible things, behaving as if hearing voices and feeling persecuted, harmed or bewitched were much less frequent in our rural cohort than in the urban cohort or the developed countries’ centres as a whole. With regard to the clinical diagnosis of schizophrenia, paranoid, hebephrenic/ disorganized and residual types were under‐represented in our samples (more so in the rural sample), and catatonic type and acute schizophrenic episode were over‐represented compared to the developed countries’ centres. Moreover, the proportion of subjects of CATEGO class S+ was lower in our samples. With regard to onset, early manifestations and clinical subtypes of schizophrenia, our rural cohort deviated most from developed countries’ centres as a whole, with our urban sample falling in between, thus indicating the role of socio‐cultural factors in general, and urbanization in particular, in these variables in schizophrenia.