神经发育危险因素与精神分裂症发病的关系

摘要

目的探讨神经发育危险因素与精神分裂症发病的关系。方法采用病前分裂样及分裂型特质量表（PSST）和病前社会适应量表（PSA），对166个家系中的310例精神分裂症患者（患者组）及307名正常同胞（对照组）进行评定和病例-对照研究，并将所有研究对象以PSST和PSA评分按照1/3位数划分为高分组、中分组、低分组进行比较。对两组神经发育危险因素进行单因素及多因素Logistic回归模型分析。结果（1）经病例-对照分析，高热惊厥及婴幼儿期患严重疾病与精神分裂症的发生有关［比数比（OR）值分别为6.05和2.64，P值为0.02和0.01］；经多因素Logistic回归模型分析，亦提示这两个因素与精神分裂症的发病有关（高热惊厥的OR=4.7，P=0.06，婴幼儿期患严重疾病的OR=2.7，P=0.02）。（2）高热惊厥、婴幼儿期患严重疾病与PSST和/或PSA高分数有一定关系。PSST及PSA的高分和中分者患精神分裂症的机会较低分者增加（P<0.001）。结论高热惊厥及婴幼儿期患严重疾病可能增加精神分裂症的易感性，这两个因素可能与儿童、青少年期的个性和社会适应不良有关。%Objective　To study the relationship between neurodevelopment risk factors and the susceptibility of schizophrenia. Methods　Three hundred and ten schizophrenic patients and their 307 normal sibs coming from 166 families were studied. Univariable and multivariable logistic regression analyses were performed to explain the relationship between neurodevelopment risk factors and schizophrenia. Results　（1） Univariable and multivariable logistic regression analyses showed that febrile convulsion and severe somatic disease during early childhood were related to the susceptibility of schizophrenia. With univariable analysis, the correlation between febrile convulsion and schizophrenia showed OR=6.05, P=0.02, severe disease showed OR=2.64, P=0.01; With multivariable analysis, febrile convulsion showed OR=4.7, P=0.06, severe disease showed OR=2.7, P=0.02. （2） Febrile convulsion and severe disease were related to high scores of PSST and/or PSA. Comparing to the individuals with low scores of PSST and PSA, individuals with high and middle score showed higher risk of schizophrenia, P<0.001. Conclusion　Febrile convulsion and severe disease during early childhood may increase the susceptibility of schizophrenia. On the other hand, febrile convulsion and severe disease may be related to the personality traits and social adjustment disorders in childhood and early adolescent, and such disorders may be related to the susceptibility of schizophrenia.