Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder - Results from a longitudinal birth cohort
Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder - Results from a longitudinal birth cohort
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DOI：
10.1001/archpsyc.59.5.449
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发表时间：
2002-05-01
影响因子：
--
通讯作者：
Poulton, R
中科院分区：
文献类型：
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作者：
Cannon, M;Caspi, A;Poulton, R
背景：儿童发育异常曾在精神分裂症中有过描述。然而，尚不清楚儿童发育障碍是精神分裂症特有的，还是仅仅是一系列精神疾病结果的标志。方法：纳入达尼丁多学科健康与发展研究的1037名1年出生队列儿童（1972-1973），每隔两年（3 - 11岁）对情感、行为和人际问题、运动和语言发展以及智力进行评估。在11岁时，儿童被问及精神病症状。在26岁时，使用诊断访谈表进行DSM-IV诊断。将患有精神分裂症样障碍的研究成员（n=36[3.7%]）与健康对照进行比较，并与诊断为躁狂症（n=20[2%]）和非精神病性焦虑或抑郁症（n=278[28.5%]）的组进行比较。结果：情绪问题和人际关系困难在儿童中被注意到，这些儿童后来达到了任何成人精神结果评估的诊断标准。然而，神经运动、接受性语言和认知发育方面的显著损伤仅在后来被诊断为精神分裂症样障碍的儿童中出现。发育障碍也预示着11岁时自我报告的精神病症状。这些损害与社会经济、产科和产妇因素的影响无关。结论：研究结果为儿童早期、持续性、泛发育障碍提供了证据，这种障碍与精神分裂症样障碍特别相关，并可预测儿童和成年期的精神病症状。
Background: Childhood developmental abnormalities have been previously described in schizophrenia. It is not known, however, whether childhood developmental impairment is specific to schizophrenia or is merely a marker for a range of psychiatric outcomes.Methods: A 1-year birth cohort (1972-1973) of 1037 children enrolled in the Dunedin Multidisciplinary Health and Development Study was assessed at biennial intervals between ages 3 and 11 years on emotional, behavioral, and interpersonal problems, motor and language development, and intelligence. At age 11 years, children were asked about psychotic symptoms. At age 26 years, DSM-IV diagnoses were made using the Diagnostic Interview Schedule. Study members having schizophreniform disorder (n=36 [3.7%]) were compared with healthy controls and also with groups diagnosed as having mania (n=20 [2%]) and nonpsychotic anxiety or depression disorders (n=278 [28.5%]) on childhood variables.Results: Emotional problems and interpersonal difficulties were noted in children who later fulfilled diagnostic criteria for any of the adult psychiatric outcomes assessed. However, significant impairments in neuromotor, receptive language, and cognitive development were additionally present only among children later diagnosed as having schizophreniform disorder. Developmental impairments also predicted self-reported psychotic symptoms at age 11 years. These impairments were independent of the effects of socioeconomic, obstetric, and maternal factors.Conclusions: The results provide evidence for an early-childhood, persistent, pan-developmental impairment that is specifically associated with schizophreniform disorder and that predicts psychotic symptoms in childhood and adulthood.