不同首发年龄精神分裂症患者临床特征及影响因素  

Clinical characteristics and related factors of patients with schizophrenia in different ages of onset

作　　者：杨凡[1] 徐沛琳 黄悦勤[2] 刘肇瑞[2] 张婷婷[2] 何燕玲[3] 章杰 龚元东 刘燕 刘波[7] 赵乐胜 吴国平 刘敏 王延军[11] 王继才[1] 高长青[11] 卢瑾[1] YANG Fan;XU Peilin;HUANG Yueqin;LIU Zhaorui;ZHANG Tingting;HE Yanling;ZHANG Jie;GONG Yuandong;LIU Yan;LIU Bo;ZHAO Lesheng;WU Guoping;LIU Min;WANG Yanjun;WANG Jicai;GAO Changqing;LU Jin(The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Cen-ter for Mental Disorders(Peking University Sixth Hospital),Beijing 100083,China;Shanghai Mental Health Centre,Shanghai 200030,China;The Third People's Hospital of Zhongshan,Zhongshan Mental Health Center,Zhongshan 528451,Guangdong Province,China;Shandong Mental Health Center,Jinan 250014,China;Jining Medical University,Jining 272013,Shandong Province,China;Jingzhou Mental Health Center,Jingzhou 434000,Hubei Province,China;The Second People's Hospital of Pu'er,Pu'er 665000,Yunnan Province,China;Chuxiong Yi Autonomous Prefecture People's Hospital of the Second,Chuxiong 675000,Yunnan Province,China;The Second People's Hospital of Yuxi City,Yuxi 653100,Yunnan Province,China;The Mental Hospital of Y unnan Province,Kunming 650224,China)

机构地区：[1]昆明医科大学第一附属医院,昆明650032 [2]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083 [3]上海市精神卫生中心,上海200030 [4]中山市第三人民医院,中山市心理卫生中心,广东中山528451 [5]山东省精神卫生中心,济南250014 [6]济宁医学院,山东济宁272013 [7]荆州市精神卫生中心,湖北荆州434000 [8]普洱市第二人民医院,云南普洱665000 [9]楚雄州第二人民医院,云南楚雄675000 [10]云南省玉溪市第二人民医院,云南玉溪653100 [11]云南省精神病医院,昆明650224

出　　处：《中国心理卫生杂志》2024年第1期16-24,共9页Chinese Mental Health Journal

基　　金：国家重点研发计划(2017YFC0907800)。

摘　　要：目的:探讨不同首发年龄精神分裂症患者的临床特征,以及社会人口学影响因素。方法:根据美国精神障碍诊断与统计手册第5版的精神分裂症诊断标准,选取15~70岁患者2016例,由精神科医生采用简明国际神经精神访谈、精神症状维度评定量表(CRDPSS)和阳性与阴性症状量表(PANSS)进行诊断和评估。以18岁和25岁作为精神分裂症早发、中发及晚发的分组界值。采用方差分析、多重相关分析和多重线性回归的方法进行统计分析。结果:早发型患者的PANSS量表总分(73.8±28.0)和CRDPSS量表总分(11.7±5.4)均为最高。女性、受教育程度高、汉族、首发年龄较早、起病形式较慢等特征与PANSS量表和CRDPSS量表总分及其各维度分数正关联(标化回归系数:0.04~0.47),收入水平和吸烟与PANSS量表和CRDPSS量表总分及其各维度分数负关联(标化回归系数:-0.04~-0.14)。结论:早发型精神分裂症患者的症状严重程度更高,女性、受教育水平高、早发病、慢性起病是精神分裂症患者症状严重的危险因素。Objective:To explore the clinical characteristics and related socio-demographic factors of schizo-phrenia patients with different ages of onset.Methods:Totally 2016 patients with schizophrenia aged 15 to 70 were selected according to the diagnostic criteria for schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition.All of the patients were interviewed by psychiatrists using the Mini International Neuropsy-chiatric Interview to diagnose schizophrenia,Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)and the Positive and Negative Syndrome Scale(PANSS)to assess symptoms.The cut-off points were 18 and 25 years old for three age groups,i.e.early onset(EOS),youth onset(YOS)and adult onset(AOS).Statistical analy-ses were performed by analysis of variance Pearson correlation analysis,and multivariate linear regression.Results:The early-onset patients had the highest total PANSS score(73.8±28.0)and CRDPSS score(11.7±5.4).Fe-male gender,high education level,Han ethnicity,early onset age,and slower onset of illness were negatively corre-lated with the total and dimension score of PANSS scale and CRDPSS scale(standardized regression coefficient:0.04-0.47),and income level and smoking were negatively correlated with those score(standardized regression coefficient:-0.04--0.14).Conclusion:Early-onset schizophrenia patients have more severe symptoms,and fe-male,high education level,early-onset disease,and chronic onset are the risk factors of symptom severity in patients with schizophrenia.

关 键 词：精神分裂症 首发年龄 简明国际神经精神访谈 精神症状维度评定量表 阳性与阴性症状量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学]