LOOKING FOR CHILDHOOD-ONSET SCHIZOPHRENIA - THE 1ST 71 CASES SCREENED
LOOKING FOR CHILDHOOD-ONSET SCHIZOPHRENIA - THE 1ST 71 CASES SCREENED
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DOI：
10.1097/00004583-199406000-00003
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发表时间：
1994-06-01
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：
MCKENNA, K;GORDON, CT;RAPOPORT, JL
目的：回顾儿童精神分裂症的转诊情况。方法：采用《学龄儿童情感障碍和精神分裂症时间表-流行病学版》、《儿童和青少年诊断访谈-家长版》的部分内容和临床访谈，从1990年至1993年期间提交给国家精神卫生研究所的共260例精神病患者中选出儿童和青少年（N = 71）及其父母进行亲自筛查。利用所有信息来源确定最佳估计诊断。研究人员使用标准化的语音录像样本对一部分受试者的思维障碍进行了评分。结果：两名儿童精神科医生对初步诊断的最佳估计的信度（kappa）范围为。65到0.81。19名儿童被诊断患有精神分裂症，这些儿童在12岁或之前发病，但在接受采访时都处于青春期。情感性障碍（N = 14）和阿斯伯格综合征和广泛性发育障碍（N = 6）也被诊断。我们观察到一大群没有被任何DSM-III-R分类完全描述的可可靠识别的儿童，他们暂时被称为“多维障碍”（N = 21），伴有多种语言或学习障碍、情绪不稳定和短暂性精神病症状。结论：儿童期精神分裂症经常被误诊，可能是因为这种疾病的罕见性和应用主要标准的模糊性。一系列发育障碍与不太普遍的儿童期精神病症状一起出现。
Objective: To review psychiatric referrals to a study of childhood-onset schizophrenia. Method: Children and adolescents (N = 71) and their parents selected from a total of 260 patients referred to the National Institute of Mental Health between 1990 and 1993, with onset of psychosis at or before age 12 years, were screened in person, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version, portions of the Diagnostic Interview for Children and Adolescents-Parent Version, and clinical interview. Best-estimate diagnoses using all sources of information were determined. Thought disorder was rated on a subset of subjects using standardized videotaped speech samples. Results: Interrater reliability (kappa) between two child psychiatrists for best-estimate primary diagnoses ranged from .65 to .81. Schizophrenia was diagnosed for 19 children who by history had had onset at or before age 12, but all were in puberty when interviewed. Affective disorders (N = 14) and Asperger's syndrome and pervasive developmental disorder not otherwise specified (N = 6) were also diagnosed. A large group of reliably identifiable children not completely described by any DSM-III-R category and provisionally called ''multidimensionally impaired'' (N = 21) with multiple language or learning disorders, mood lability, and transient psychotic symptoms was seen. Conclusions: Childhood-onset schizophrenia is often misdiagnosed, perhaps because of the rarity of the disorder and the ambiguity in applying primary criteria. An array of developmental disturbances are seen with less pervasive childhood-onset psychotic symptoms.