精神分裂症住院患者不同发病年龄临床症状及症状结构比较

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-03-01 DOI:10.1016/j.schres.2025.03.015

Zhaofan Liu , Xiaoying Wang , Wenjin Chen , Junchao Huang , Jinghui Tong , Jue Wang , Ran Liu , Hu Deng , Kebing Yang , Wei Li , Song Chen , Ting Xie , Li Tian , Fude Yang , Baopeng Tian , Yanli Li , Chiang-Shan R. Li , Yunlong Tan

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引用次数: 0

摘要

目的探讨早发型精神分裂症（EOS）、典型发型精神分裂症（TOS）和晚发型精神分裂症（LOS）住院患者临床症状特征和症状网络结构的差异。方法采用阳性和阴性综合征量表（PANSS）对来自开放数据集的654例EOS、1664例TOS和369例LOS住院精神分裂症患者进行症状严重程度评估。比较三个发病年龄组的症状严重程度。构建症状网络，并采用中间性和紧密中心性等测量方法来研究症状之间的互联性。结果与TOS和LOS相比，os住院患者表现出更严重的症状，主要是由于更严重的阴性症状和一般精神病理。对症状网络的分析显示，不受控制的敌意是EOS、TOS和LOS的核心特征。在EOS网络中，焦虑域作为桥梁症状，而积极和无组织的思想与疾病表现密切相关。TOS住院患者表现出与EOS相似的模式，但TOS在阳性和阴性症状上表现出更高的中间性和更低的亲密性，表明这些域在整体网络连通性中起着至关重要的作用。在LOS中，阳性症状表现出高度的中间性中心性，表明它们在网络连接中起着关键作用。结论精神分裂症住院患者的症状严重程度和症状网络结构在不同发病年龄组间存在差异。更深入地了解这些网络层面的差异可以揭示不同的发病机制，并指导精神分裂症个性化治疗策略的发展。假设一直观察到，早发性精神分裂症（EOS）住院患者的治疗效果比典型发作性精神分裂症（TOS）差，而迟发性精神分裂症（LOS）住院患者的治疗效果往往比典型发作性精神分裂症住院患者好。这些现象背后的原因尚不清楚。在这项工作中，我们的目标是利用网络分析来揭示潜在的症状相互作用，这些相互作用可能有助于在不同年龄的精神分裂症住院患者群体中观察到不同的治疗结果。

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Comparison of clinical symptoms and symptom structure across different onset ages in schizophrenia inpatients

Objective

This study aimed to explore differences in clinical symptom profiles and symptom network structures of inpatients with schizophrenia among early-onset schizophrenia (EOS), typical-onset schizophrenia (TOS), and late-onset schizophrenia (LOS) patients.

Methods

Symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) in 654 EOS, 1664 TOS, and 369 LOS inpatients with schizophrenia from an open dataset. Symptom severity comparisons were conducted among the three age of onset groups. Symptom networks were constructed, and measurements such as betweenness and closeness centrality were employed to investigate the interconnectivity between symptoms.

Results

EOS inpatients exhibited significantly more severe symptoms compared to TOS and LOS, primarily attributable to more severe negative symptoms and general psychopathology. Analysis of the symptom networks revealed that uncontrolled hostility emerged as a core feature across EOS, TOS, and LOS. In the EOS network, anxiety domain served as bridge symptoms, while positive and disorganized thought were strongly associated with disease manifestations. TOS inpatients exhibited a similar pattern to EOS, but TOS showed higher betweenness and lower closeness in positive and negative symptoms, indicating that these domains play a crucial role in the overall network connectivity. In LOS, positive symptoms showed high betweenness centrality, suggesting their pivotal role in network connectivity.

Conclusions

These findings suggest that the symptom severity and symptoms network structure differ across different age of onset groups in schizophrenia inpatients. A deeper understanding of these network-level differences could shed light on the distinct pathogenesis mechanisms and guide the development of personalized treatment strategies for schizophrenia.

Hypothesis

It has been consistently observed that inpatients with early-onset schizophrenia (EOS) have poorer treatment outcomes compared to typical-onset schizophrenia patients (TOS), while those with late-onset schizophrenia (LOS) tend to have better outcomes than typical-onset inpatients. The reasons behind these phenomena remain unclear. In this work, we aim to utilize network analysis to uncover potential symptom interactions that may contribute to the different treatment outcomes observed across different ages of onset schizophrenia inpatient groups.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.