Early versus late risk factors for deficit and nondeficit schizophrenia

IF 5.2 3区 医学 Q1 PSYCHIATRY
Setareh Alabaf , Brian Kirkpatrick , Shanquan Chen , Rudolf N. Cardinal , Emilio Fernandez-Egea
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引用次数: 5

Abstract

Aim

We examined whether timing of known risk factors for schizophrenia may influence the development of schizophrenia with primary negative symptoms.

Method

This cross-sectional single-centre study in England used a clinical cohort of 167 clozapine-treated schizophrenia patients. Deficit and nondeficit schizophrenia models were used as clinical proxies of patients with and without primary negative symptoms respectively. Patients were assessed using the Schedule for the Deficit Syndrome. We examined previously replicated risk factors (family history of psychosis, advanced paternal age, male gender, birth weight <3000 g, summer birth, cannabis use, exposure to physical or sexual abuse and/or bullying) as well as other traumatic events for deficit and nondeficit schizophrenia.

Results

We found a distinct risk factor pattern for the two groups. Compared to the nondeficit group, patients with deficit schizophrenia reported a significantly lower prevalence of cannabis use (p = 0.005) at the time of first-episode psychosis (FEP), physical or sexual abuse (p = 0.033) prior to FEP, less exposure to crime-related traumatic events (p = 0.012) and significantly associated with summer birth (p = 0.017). The groups did not differ in terms of family history of psychosis, advanced paternal age, male gender, or low birth weight. To account for multiple comparisons, a confirmatory analysis was performed using logistic regression which yielded similar results except that summer birth no longer reached statistical significance.

Conclusion

Our results suggest the timing of the insult may influence the symptom presentation, with insults later in life (cannabis or traumatic events) being associated with psychotic presentation and less with primary negative symptoms.

缺乏性和非缺乏性精神分裂症的早期和晚期危险因素
我们研究了已知的精神分裂症危险因素的时间是否会影响原发阴性症状的精神分裂症的发展。方法在英国进行的一项横断面单中心研究纳入了167例氯氮平治疗的精神分裂症患者的临床队列。以有原发性阴性症状和无原发性阴性症状的精神分裂症患者分别采用缺陷型和非缺陷型精神分裂症模型作为临床指标。采用缺陷综合征量表对患者进行评估。我们检查了先前重复的风险因素(精神病家族史、父亲高龄、男性、出生体重(3000克)、夏季出生、大麻使用、遭受身体或性虐待和/或欺凌)以及其他创伤性事件对缺陷和非缺陷精神分裂症的影响。结果我们发现两组患者有明显的危险因素模式。与非缺陷组相比,缺陷精神分裂症患者在首次精神病发作(FEP)时使用大麻的患病率(p = 0.005),在FEP之前遭受身体或性虐待(p = 0.033),较少接触与犯罪相关的创伤事件(p = 0.012),并与夏季出生显著相关(p = 0.017)。两组在精神病家族史、父亲年龄、男性性别或低出生体重方面没有差异。为了解释多重比较,使用逻辑回归进行了验证性分析,除了夏季出生不再达到统计显著性外,结果相似。结论:我们的研究结果表明,侮辱的时间可能会影响症状的表现,晚年的侮辱(大麻或创伤事件)与精神病症状的表现有关,而与原发性阴性症状的关系较小。
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来源期刊
自引率
3.30%
发文量
58
期刊介绍: The Spanish Journal of Psychiatry and Mental Health (SJPMH), incorporated into ISSN 1888-9891, is the official scientific publication of the Spanish Society of Psychiatry and Mental Health. The journal focuses on studying mental illnesses, their pathological processes, and their psychosocial consequences, and aims to disseminate scientific advances in all areas related to mental health and illness. SJPMH accepts unpublished works on psychiatry and mental health, including their medical and social implications. The journal provides space for research in the biological, clinical, and psychosocial fields. Manuscripts undergo peer-review by external reviewers before being accepted for publication. SJPMH is indexed in Index Medicus/Medline, IBECS, Social Sciences Citation Index Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Sciences.
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