児童期発症精神分裂病の特徴と前駆期の強迫症状の有無による下位分類に関する検討

Abstract

Patients with childhood-onset schizophrenia frequently show obsessive-compulsive symptoms in the prodromal phase. The aim of this study was to investigate the differences between the characteristics of schizophrenia with and without obsessive-compulsive symptoms in the probromal phase. Findings are summarized as follows : 1) Of patients with schizophrenia diagnosed by the DSM-Ⅲ-R, 50 who developed the disease at under 15 years of age (childhood-onset group) and 35 who developed the disease at over 20 years of age (adulthood-onset group) were compared. The childhood-onset group was found to include many subjects who developed obsessive-compulsive symptoms in the prodromal phase (21/50) ; prevalent clinical symptoms were poverty of speech, magical thinking, lability of mood and delusion of observation ; less prevalent clinical symptoms were auditory hallucination and delusion of persecution. 2) Subjects in the childhood-onset group were subdivided into 21 subjects who developed obsessive-compulsive symptoms in the prodromal phase (childhood-onset (+) group) and 29 without obsessive-compulsive symptoms (childhood-onset (-) group). Comparison was made between the two groups and with the adulthood-onset group. Males accounted for the majority of the childhood-onset (+) group (20/21). Other parameters involving major group-to-group differences were onset type, brain CT findings, family history of psychotic disorders, premorbid personality, clinical symptoms, and Global Assessment of Functioning Scale (GAF Scale) score at 3 years after onset. These findings suggest the possibility of classifying childhood-onset schizophrenia into subtypes according to the presence or absence of obsessive-compulsive symptoms in the prodromal phase.