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Yıl:1998; Cilt: 8; Sayı: 4>> Özet
Klinik Psikofarmakoloji Bülteni; 1998;8(4):183-191
Erken başlangıçlı şizofreninin uzun süreli gidişi
C Eggers
University of Essen Clinic for Child and Adolescent Psychiatry \r\n\r\n
Bu çalışmada çocukluk dönemi başlangıçlı 44 şizofrenik hastanın 42 yıl süreyle uzun dönem takip sonuçları sunulmuştur (başlangıç yaşı:7-14 yaş). 57 hastadan oluşan orjinal örneklemden 13 hasta ya ölüm ya da bilinmeyen adrese taşınma nedenleriyle izlenememiştir. Bununla birlikte, bu hastalar çalışmada kalan 44 hastaya göre cinsiyet, ilk psikotik semptomların ortaya çıkış yaşı ve ilk hecme süresince PANNS negatif, pozitif ve global ortalama semptom sıklığı açısından farklılık göstermiyorlardı. İlk psikiyatrik semptomların ortaya çıkış yaşı, ilk psikotik semptomların başlama yaşı ve ilk hastaneye yatış yaşı açısından cinsiyet farklılığı yoktu. Kümülatif prevalans açısından cinsiyet, bir gruplama faktörü olarak ele alındığında; KAPLAN-MEIER's analizi ilk psikotik semptomların başlama yaşının kadınlarda (7-15 yaş) erkeklere (10-18 yaş) göre daha erken olduğunu gösterdi. İkinci izleme sürecinde tüm örneklemin (N=44) % 50' si tam ya da kısmi; % 50 si kötü düzeyde remisyona girdi. Çok erken başlangıçlı 11 şizofrenik (£ 10 yaş) hastadan oluşan grupta sinsi başlangıç tüm örneklemden daha sıktı. 33 hasta (%75) akut, 11 hasta (%25) sinsi başlangıç göstermişti. Çok erken başlangıçlı 11 şizofrenik hastanın yalnızca birinde premorbid anormallikler yoktu (M-PAS=0). Oysa ki diğer 10 hastada bu puan 5-8 arasındaydı. 11 yaş öncesi erken başlangıç yüksek sosyal yetersizlik puanlarıyla korele idi. Çok erken başlangıçlı 11 hastanın 8 tanesi çok kötü sosyal uyum gösteriyordu (DAS 3.0=4 veya 5).




The long-term course of early onset schizophrenia
We present the results of a 42 [year]s long-term follow-up of 44 patients (19 males, 25 females) with childhood onset schizophrenia (COS, age at onset: 7 - 14 [year]s). The 44 patients could be traced for a 2nd follow-up examination 27 [year]s after the first follow-up. 13 patients of the original sample of 57 had died or moved away with unknown destination. The group of the lost patients, however, did not differ from the remaining 44 patients in gender, age of first psychotic symptoms (AFPS), mean frequencies of positive, negative and global symptoms of the PANSS during the first episode. There have been no gender differences in age of first psychiatric symptoms (AFS), AFPS, and age of first hospitalization. KAPLAN-MEIER's survival-analysis carried out for AFPS with sex as grouping factor revealed that the cumulative prevalence is earlier in females (between 7 and 15 [year]s) than in males (between 10 and 18 [year]s). 50 % of the whole sample (n =44) were completely or partially and 50 % only poorly remitted at the second follow-up. In the subgroup of 11 patients with very early onset schizophrenia (VEOS, age £ 10 [year]s) the insidious type of onset was more frequent than in the whole sample, where 33 patients (75 %) had an acute and 11 (25 %) an insidious type of onset. Only 1 of the 11 VEOS-patients did not show premorbid abnormalities (M-PAS = 0) whereas in the other 10 patients the M-PAS scores were between 5 and 8 points. An early onset before the age of 11 was correlated with high social disability scores, 8 of the 11 VEOS-subjects had a poor to very poor social adjustment (DAS 3.0 = 4 or 5).

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