儿童精神分裂症患者的病前社会能力及行为特征与病后颅脑结构  

Premorbid social competence,behavioral characteristics and the brain structure after diagnosed the disease in children with schizophrenia

作　　者：郭素芹[1] 朱俊敬 邵荣荣[1] 盖关臣 郭芳[1] 李玉玲[1] 张红梅[1] 郭敬华[1] 

机构地区：[1]新乡医学院第二附属医院儿童少年精神科,河南新乡453002 [2]郑州市第八人民医院儿童少年精神科,郑州450006

出　　处：《中国心理卫生杂志》2014年第6期445-451,共7页Chinese Mental Health Journal

基　　金：河南省重点科技攻关项目(082102310037)

摘　　要：目的：探讨儿童精神分裂症患者病后颅脑结构与病前社会能力和行为特征之间的关系.方法：选取符合美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）精神分裂症诊断标准的儿童患者224例及222名正常对照.采用Achenbach儿童行为量表（CBCL）,回顾性调查6～10岁时的社会能力及行为问题,用磁共振成像（MRI）检测213例患儿病后的颅脑结构.根据CBCL社会能力总分及行为问题总分的中位数将213例患儿分为社会能力低分组（n=106）及高分组（n=107）、行为问题低分组（n=106例）及高分组（n =107）.结果：经多重检验校正后,儿童精神分裂症组的CBCL社交退缩、攻击性、行为问题总分[（28.7±23.3） vs.（17.0±9.1）,P〈0.05]均高于对照组,社会能力总分[（12.4±3.9） vs.（13.9±2.9）,P 〈o.05]低于对照组.协方差分析显示,CBCL社会能力总分低分组患者右颞角宽度[（4.9±1.1） mmvs.（4.4±0.6） mm]及顶叶脑沟宽[（5.5±1.2）mmvs.（4.6±0.9） mm]大于高分组患者（均P 〈0.05）,三脑室侧壁至左脑岛面距[（31.1±3.5） mmvs.（32.6±2.1） mm]及胼胝体厚[（8.1±0.9） mmvs.（8.6±0.9） mm]小于高分组患者（均P〈0.05）;CBCL行为问题总分低分组患者顶叶脑沟宽[（4.8±1.0） mmvs.（5.3±1.2） mm]、左外侧裂脑沟根部宽[（17.4±3.5） mmvs.（18.3±4.1）mm]小于高分组患者（均P〈0.01）.结论：儿童精神分裂症患者病前社会能力越低或行为问题越多,病后脑室扩大和脑结构异常可能越明显.Objective： To explore the relation of brain structure after diagnosed schizophrenia to premorbid so- cial competence and behavioral characteristics in children with schizophrenia. Methods： Totally 224 children with schizophrenia meeting with the criterion of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） and 222 healthy children were selected. They were retrospectively surveyed with the Achenbach＇s Child Behavior Check-list （CBCL） to assess their social competence and behavioral characteristics at the age from 6 to 10 years. The brain structure after diagnosed schizophrenia of 213 children who cooperate to check were detected with magnetic resonance imaging （MRI）. These 213 children were arranged to low score group and high score group ac- cording to median of the social competence and behavioral problem total score in CBCL, namely, the low social competence total score group （n = 106） and the high score group （n = 107）, low behavioral problem total score group （n=106） and high score group （n = 107）. Results： After multiple test correction, the schizophrenia group had higher CBCL scores in social withdrawal factor, offensive factor, behavioral problem total score [ （28.7 ± 23.3） vs. （ 17.0±9. 1 ）, P 〈 0. 05 ] and lower social competence total scores [ （ 12.4 ± 3.9） vs. （ 13.9 ± 2. 9）, P 〈 0.05 ] than the normals. Compared to the patients with higher social competence total scores, the ones with lower scores had larger right horn of temporal [（4. 9 ± 1.1） mm vs. （4. 4 ± 0. 6） mm, P 〈 0. 05] and width of parietal sulci [（5.5±1.2） mm vs. （4. 6±0. 9） mm, P 〈0. 05], and smaller distance from lateral wall of third ventricle to left surface of insula [ （31.1 ± 3.5） mm vs. （32. 6 ±2. 1） mm, P 〈 0. 05 ] and depth of corpus callosum [ （ 8. 1 ± 0. 9） mm vs. （8.6 ±0. 9）mm, P 〈0. 05]. Compared to the patients with higher behavioral problem total scores, the ones with lower scores had smal

关 键 词：精神分裂症 儿童 儿童行为量表 磁共振成像 横断面研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.94[医药卫生—临床医学]