| 首发儿童精神分裂症患者行为特征与颅脑结构的关系 |
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| 引用本文： | 朱俊敬,郭素芹,梁颖慧,邵荣荣.首发儿童精神分裂症患者行为特征与颅脑结构的关系[J].中国学校卫生,2018,39(7):1018-1021. |
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| 作者姓名： | 朱俊敬 郭素芹 梁颖慧 邵荣荣 |
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| 作者单位： | 河南省郑州市第八人民医院儿童青少年心理科, 450006 |
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| 摘 要： | 探讨首发儿童精神分裂症患者行为特征与颅脑结构的差异,为儿童精神分裂症的早期发现及预防提供依据.方法 根据美国精神障碍诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,DSM-Ⅳ)精神分裂症的诊断标准,选取在新乡医学院第二附属医院住院就诊的96例首发儿童精神分裂症患儿为病例组,以49名正常儿童为对照组1,100名正常儿童为对照组2.采用3.0 T磁共振成像(MRI)检测对照组1及病例组儿童的颅脑结构,用Achenbach儿童行为量表(CBCL)回顾性评估所有对照组2及病例组611岁儿童的行为特征.结果 病例组儿童的第三脑室横径及侧脑室前脚均高于对照组1(t值分别为3.00,2.13,P值均<0.05),胼胝体体部厚度、尾状核头部宽度、海马厚度均低于对照组1(t值分别为-2.44,-7.68,-5.07,P值均<0.05).病例组的社会能力总分及学校情况因子分均低于对照组2(t/Z值分别为-4.30,4.85,P值均<0.01),行为问题总分及社交退缩、分裂强迫、攻击因子分均高于对照组2(Z值分别为3.00,2.56,2.75,3.66,P值均<0.05).社会能力总分与胼胝体体部厚度、扣带回、尾状核体部长度、海马宽度及海马厚度均呈正相关;行为问题总分与尾状核体部长度及海马宽度均呈负相关(P值均<0.05).结论 首发儿童精神分裂症患者病前存在较低的社会能力及较多的行为问题,患病后存在脑室扩大和颅脑结构异常;患病前社会能力越低或行为问题越多,患病后脑室扩大和颅脑结构异常越明显.
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| 关 键 词： | 精神分裂症 儿童 行为 脑 |
Association of abnormal behavior with brain structure in first-episode childhood schizophrenia |
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| Abstract: | Objective To explore the relation of behavior characteristics and brain structure in the first-episode childhood schizophrenia.Methods Totally 96 children with schizophrenia meeting with the criterion of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) and 49 healthy children were selected as control group one, and another 100 healthy children were selected as control group two.The brain structure of 96 children and 49 healthy children were detected with magnetic resonance imaging (MRI).Achenbach 's Child Behavior Checklist (CBCL) was used to assess social competence and behavioral characteristics of all participants.Results The schizophrenia group had higher transverse diameter of third ventricle, lateral ventricle anterior horn (t = 3.00, 2.13, P<0.05) and lower corpus callosum thickness, caudate head width, hippocampus thickness than the control group (t =-2.44, -7.68, -5.07, P<0.05).Schizophrenia children had higher scores in behavioral problem, social withdrawal, cleavage coercion and offensive factor (Z = 3.00, 2.56, 2.75, 3.67, P<0.05) and lower social competence and school situation compared with control group (t =-4.30, Z = 4.85; P<0.01).Social competence was significantly positively correlated with corpus callosum thickness, gyrus cingulatus, caudate length, the width of the hippocampus and hippocampus thickness.Behavioral problem total scores were inversely correlated with caudate length and the width of the hippocampus.Conclusion The first-episode childhood schizophrenia have lower social competence and more behavioral problems in pre-symptom period.Ventricle enlargement and brain structural abnormalities following onset of the disease are observed.Behavioral problem and the social competence get worse with significant ventricle enlargement and brain structural abnormalities. |
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