Saliha Baykal, Abdullah Bozkurt, Cansu Çobanoğlu Osmanlı, Bedia Sultan Önal, Berkan Şahin, Zeynep Nur Karadoğan, Mehmet Karadağ, Zehra Hangül, Fethiye Kılıçaslan, Hamza Ayaydın, Necati Uzun, Esen Yıldırım Demirdöğen, Mehmet Akif Akıncı, Öznur Bilaç, Ahmet Büber, Ali Evren Tufan, Gülen Güler Aksu, Hande Ayraler Taner, Burcu Akın Sarı, Meryem Özlem Kütük, Duygu Kaba, Müge Karaçizmeli, Rabia Kavcıoğlu, Işık Görker, Koray Karabekiroğlu
{"title":"早期和儿童期精神分裂症临床特征和病程预测因素的比较。","authors":"Saliha Baykal, Abdullah Bozkurt, Cansu Çobanoğlu Osmanlı, Bedia Sultan Önal, Berkan Şahin, Zeynep Nur Karadoğan, Mehmet Karadağ, Zehra Hangül, Fethiye Kılıçaslan, Hamza Ayaydın, Necati Uzun, Esen Yıldırım Demirdöğen, Mehmet Akif Akıncı, Öznur Bilaç, Ahmet Büber, Ali Evren Tufan, Gülen Güler Aksu, Hande Ayraler Taner, Burcu Akın Sarı, Meryem Özlem Kütük, Duygu Kaba, Müge Karaçizmeli, Rabia Kavcıoğlu, Işık Görker, Koray Karabekiroğlu","doi":"10.1111/eip.13594","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to compare the clinical characteristics of childhood-onset schizophrenia (COS) and early-onset schizophrenia (EOS) during the first- episode psychosis and the stable period, to examine psychopharmacological treatment approaches, and to investigate potential predictive factors for prognosis.</p><p><strong>Methods: </strong>Demographic, clinical, and psychopharmacological therapy data for 31 patients diagnosed with COS and 66 with EOS were retrieved from the file records in this multicenter study. Symptom distribution and disease severity and course were evaluated twice, in the acute psychotic stage and in the latest stable phase, during follow-up using the positive and negative syndrome scale (PANSS) and clinical global impression (CGI) scales.</p><p><strong>Results: </strong>A statistically significant difference was observed between the groups' CGI improvement rates and median last stable stage PANSS positive, negative, and general psychopathology symptom scores (p = .005, p = .031, p = .005, and p = .012, respectively). Premorbid neurodevelopmental disorder and obsessive-compulsive disorder and comorbidities were more common in the COS group (p = .025 and p = .030, respectively), and treatment required greater multiple antipsychotic use in that group (p = .013). When the independent variables affecting the difference between pre- and post-treatment PANSS scores were examined using linear regression analysis, the model established was found to be statistically significant (F = 5.393; p = .001), and the group variable (p = .024), initial disease severity (p = .001), and socioeconomic level (p = .022; p = .007) emerged as predictive factors for the disease course.</p><p><strong>Conclusion: </strong>Although early diagnosis and treatment is an important factor in improving prognosis in schizophrenia, more specific predictors for schizophrenia need to be identified. Additionally, preventive programs and pharmacological methods need to be developed in children with neurodevelopmental problems, particularly those from low socioeconomic status families.</p>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":" ","pages":"e13594"},"PeriodicalIF":2.1000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comparison of clinical characteristics and course predictors in early- and childhood-onset schizophrenia.\",\"authors\":\"Saliha Baykal, Abdullah Bozkurt, Cansu Çobanoğlu Osmanlı, Bedia Sultan Önal, Berkan Şahin, Zeynep Nur Karadoğan, Mehmet Karadağ, Zehra Hangül, Fethiye Kılıçaslan, Hamza Ayaydın, Necati Uzun, Esen Yıldırım Demirdöğen, Mehmet Akif Akıncı, Öznur Bilaç, Ahmet Büber, Ali Evren Tufan, Gülen Güler Aksu, Hande Ayraler Taner, Burcu Akın Sarı, Meryem Özlem Kütük, Duygu Kaba, Müge Karaçizmeli, Rabia Kavcıoğlu, Işık Görker, Koray Karabekiroğlu\",\"doi\":\"10.1111/eip.13594\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>The aim of this study was to compare the clinical characteristics of childhood-onset schizophrenia (COS) and early-onset schizophrenia (EOS) during the first- episode psychosis and the stable period, to examine psychopharmacological treatment approaches, and to investigate potential predictive factors for prognosis.</p><p><strong>Methods: </strong>Demographic, clinical, and psychopharmacological therapy data for 31 patients diagnosed with COS and 66 with EOS were retrieved from the file records in this multicenter study. Symptom distribution and disease severity and course were evaluated twice, in the acute psychotic stage and in the latest stable phase, during follow-up using the positive and negative syndrome scale (PANSS) and clinical global impression (CGI) scales.</p><p><strong>Results: </strong>A statistically significant difference was observed between the groups' CGI improvement rates and median last stable stage PANSS positive, negative, and general psychopathology symptom scores (p = .005, p = .031, p = .005, and p = .012, respectively). Premorbid neurodevelopmental disorder and obsessive-compulsive disorder and comorbidities were more common in the COS group (p = .025 and p = .030, respectively), and treatment required greater multiple antipsychotic use in that group (p = .013). When the independent variables affecting the difference between pre- and post-treatment PANSS scores were examined using linear regression analysis, the model established was found to be statistically significant (F = 5.393; p = .001), and the group variable (p = .024), initial disease severity (p = .001), and socioeconomic level (p = .022; p = .007) emerged as predictive factors for the disease course.</p><p><strong>Conclusion: </strong>Although early diagnosis and treatment is an important factor in improving prognosis in schizophrenia, more specific predictors for schizophrenia need to be identified. 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引用次数: 0
摘要
目的:本研究旨在比较童年型精神分裂症(COS)和早发型精神分裂症(EOS)在首次发作期和稳定期的临床特征,研究精神药物治疗方法,并调查预后的潜在预测因素:从这项多中心研究的档案记录中检索了 31 名被诊断为 COS 的患者和 66 名被诊断为 EOS 的患者的人口统计学、临床和精神药物治疗数据。在随访期间,使用阳性和阴性综合征量表(PANSS)和临床总体印象量表(CGI)对急性精神病期和最近的稳定期的症状分布、疾病严重程度和病程进行了两次评估:结果:两组的 CGI 改善率和最后稳定期 PANSS 阳性、阴性和一般精神病理症状评分中位数之间存在统计学差异(分别为 p = .005、p = .031、p = .005 和 p = .012)。COS组的病前神经发育障碍和强迫症以及合并症更常见(分别为p = .025和p = .030),治疗中需要使用更多的多重抗精神病药物(p = .013)。当使用线性回归分析研究影响治疗前和治疗后PANSS评分差异的独立变量时,发现所建立的模型具有统计学意义(F = 5.393; p = .001),组别变量(p = .024)、初始疾病严重程度(p = .001)和社会经济水平(p = .022; p = .007)成为疾病进程的预测因素:结论:尽管早期诊断和治疗是改善精神分裂症预后的重要因素,但仍需确定更多具体的精神分裂症预测因素。此外,还需要针对有神经发育问题的儿童,尤其是来自社会经济地位较低家庭的儿童,制定预防计划和药物治疗方法。
A comparison of clinical characteristics and course predictors in early- and childhood-onset schizophrenia.
Aim: The aim of this study was to compare the clinical characteristics of childhood-onset schizophrenia (COS) and early-onset schizophrenia (EOS) during the first- episode psychosis and the stable period, to examine psychopharmacological treatment approaches, and to investigate potential predictive factors for prognosis.
Methods: Demographic, clinical, and psychopharmacological therapy data for 31 patients diagnosed with COS and 66 with EOS were retrieved from the file records in this multicenter study. Symptom distribution and disease severity and course were evaluated twice, in the acute psychotic stage and in the latest stable phase, during follow-up using the positive and negative syndrome scale (PANSS) and clinical global impression (CGI) scales.
Results: A statistically significant difference was observed between the groups' CGI improvement rates and median last stable stage PANSS positive, negative, and general psychopathology symptom scores (p = .005, p = .031, p = .005, and p = .012, respectively). Premorbid neurodevelopmental disorder and obsessive-compulsive disorder and comorbidities were more common in the COS group (p = .025 and p = .030, respectively), and treatment required greater multiple antipsychotic use in that group (p = .013). When the independent variables affecting the difference between pre- and post-treatment PANSS scores were examined using linear regression analysis, the model established was found to be statistically significant (F = 5.393; p = .001), and the group variable (p = .024), initial disease severity (p = .001), and socioeconomic level (p = .022; p = .007) emerged as predictive factors for the disease course.
Conclusion: Although early diagnosis and treatment is an important factor in improving prognosis in schizophrenia, more specific predictors for schizophrenia need to be identified. Additionally, preventive programs and pharmacological methods need to be developed in children with neurodevelopmental problems, particularly those from low socioeconomic status families.
期刊介绍:
Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.