青少年期首发精神分裂症病前适应状态及临床症状

The pre illness adaptation and clinical symptoms of the first episode of schizophrenia in adolescence

目的 探讨青少年期首发精神分裂症的病前适应状态及临床症状。方法 选择2022年1~12月就诊于浙江省杭州市第七人民医院的80例精神分裂症患者,将其中45例青少年期(年龄<18岁)首发精神分裂症患者纳入青少年组,35例成年期(年龄≥18岁)首发精神分裂症患者归为成年组。调查并比较两组病前适应状态及临床症状。结果 青少年期组病情孤僻、同伴关系及学校适应性状态评分均较成年期组高,差异有统计学意义(P<0.05);青少年期组简明精神病量表(BPRS)焦虑忧郁因子及激活性因子评分高于成年期组,而缺乏活力因子、敌对猜疑因子评分低于成年期组,差异有统计学意义(P<0.05);与成年期组相比,青少年期组工作记忆和注意、精细运动评分均更低,差异有统计学意义(P<0.05)。结论 青少年期首发精神分裂症患者的病前适应状态较成年期精神分裂症患者差,焦虑忧郁、激活性症状更突出,且认知功能受损更明显,提示其发病机制可能不同。

Objective To investigate the pre illness adaptation and clinical symptoms of first-episode schizophrenia in adolescence.Methods From January to December 2022,80 schizophrenic patients in Hangzhou Seventh People’s Hospital,were selected.Among them,45 patients with first onset schizophrenia in adolescence(age<18 years)were included in the adolescent group,and 35 patients with first onset schizophrenia in adulthood(age≥18 years)were included in the adult group.The pre illness adaptation and clinical symptoms of the two groups were investigated and compared.Results The scores of loneliness,peer relationship and school adaptability in adolescent group were higher than those in adult group(P<0.05);The scores of anxiety depression factor and activation factor of BPRS in adolescent group were higher than those in adult group,while the scores of inactive factor and hostile suspicion factor in adolescent group were lower than those in adult group(P<0.05);Compared with the adult group,the scores of working memory,attention and fine motor in the adolescent group were lower(P<0.05).Conclusion Adolescent first-episode schizophrenia patients have poorer preoperative adaptation compared to adult schizophrenia patients.Anxiety,depression,activation symptoms,and cognitive impairment are more prominent in adolescent first-episode schizophrenia,indicating that its pathogenesis may be different.