精神分裂症遗传的性别差异

目的：探讨精神分裂症遗传的性别差异。方法：对1013例精神分裂症患者不同性别家族史阳性率，不同性别父系、母系、同胞、子女患病情况，不同性别先证者一、二、三级亲属患病情况进行比较。结果：男性有遗传史者11．9％，女性24．3％，男性低于女性，差异显著。女性同胞患病构成比明显高于男性，差异有显著性。男女一级亲属患病高于二级亲属，二级亲属患病高于三级亲属。结论：精神分裂症与遗传密切相关。     

精神分裂症家族史性别差异调查

目的 了解不同性别精神分裂症遗传的差异及父系、母系阳性家族史的差异.方法 对长沙市城、乡在我院住院的及同时段各社区进行免费药物求助的共1938例精神分裂症患者进行精神障碍遗传的问卷调查,发现精神分裂症阳性家族史患者253例,其中男性139例,女性114例.对家族史阳性率,先证者父系、母系、同胞子女患病情况作统计分析.结果 男性阳性家族史比率较女性稍低,但无统计学意义;父系、母系、同胞子女的阳性家族史无明显性别差异;母系阳性家族史明显高于父系.结论 遗传因素对精神分裂症有很大的影响,不同性别精神分裂症的阳性家族史无明显差异.精神分裂症中母系后代比父系后代有更高的发病风险.     

家族性与散发性精神分裂症的病原学研究

目的：研究家族性与散发性精神分裂症相关因素。方法：采用病历记载和家属核实的方法。对501例精神分裂症患者的家族史（限于一级亲属）、性别、发病年龄进行对比分析研究。结果：FH 较FH-组发病年龄早，FH-女性组较FH 女性组及FH ，FH-男性组发病年龄晚，均有统计学意义，而FH 男性组与女性组发病年龄无差异。结论：家族性与散发性精神分裂症在发病年龄上的性别现象为：有阳性家族史者发病年龄早，家族史阴性男性较女性发病年龄早。     

单次发作躁狂症遗传的性别差异

目的比较单次发作躁狂症遗传的两性异同。方法整群连续抽取单次发作躁狂症阳性家族史患者75例：按性别划分为女性组31例；男性组44例。对先证者一、二、三级亲属患病情况；父系、母系、同胞、子女患病情况；亲属患病个数；胎次等采用卡方检验和t检验做统计学分析。结果单次发作躁狂症遗传两性间无显著性差异（P均〉0．05）；但两性家族史阳性者共同显示一级亲属患病显著较多，三级亲属患病显著较少；且生活事件在疾病发生中起明显作用。结论单次发作躁狂症两性发病均与遗传有密切关系，生活事件对患病影响明显。     

精神分裂症的性别差异

目的:探讨精神分裂症患者的性别差异。方法:收集240例不同性别精神分裂症患者的首次发病年龄、病程、阳性家族史、临床症状、病前人格和诊断分型等资料,并进行分析比较。结果:首次发病年龄、病程和阳性家族史无性别差异,读心症、钟情妄想、其他妄想、思维逻辑性障碍和怪异行为等阳性症状在男性患者组和女性患者组中的分布差异有显著性,其他阳性症状及阴性症状在两组中的分布差异无显著性。结论:精神分裂症患者的阳性症状存在性别差异,女性精神分裂症患者的临床症状多表现为阳性症状。     

家族史和性别对精神分裂症精神病理学结构的影响

为了解家族史和性别对精神分裂症精神病理学构成的影响及联合效应，对符合中国精神疾病分类方案与诊断标准第２版精神分裂症诊断标准的１９４例病人进行简明精神病评定量表评定，并依性别和家族史分组。结果显示，单因素分析时，家族性精神分裂症阴性症状构成显著高于散发性精神分裂症，而阳性症状构成显著低于散发性精神分裂症；同时还发现，男性精神分裂症非特异性症状构成显著高于女性精神分裂症。双因素分析时，男性家族性精神分裂症阳性症状构成显著低于女性散发性精神分裂症，散发组男性非特异症状构成显著高于女性，提示性别、家族史对精神分裂症某些精神病理现象有影响，且有联合效应。     

情感障碍和精神分裂症的遗传调查与分析

目的　探讨情感障碍和精神分裂症的遗传学差异。方法　收集首次住我院并符合CCMD - 3诊断标准的情感障碍及精神分裂症病例 ,以有无家族史按诊断分组对照分析。结果　同类疾病比较 ,女性情感障碍家族史阳性率高于男性情感障碍家族史阳性率 ,女性精神分裂症家族史阳性率高于男性精神分裂症家族史阳性率。同性别不同疾病比较 ,即男性精神分裂症与男性情感障碍比较 ,女性精神分裂症与女性情感障碍比较 ,仅见女性精神分裂症家族史阳性率高于女性情感障碍家族史阳性率。另外 ,还发现不论是精神分裂症还是情感障碍 ,均见Ⅰ级亲属家族史阳性率高于Ⅱ级 ,Ⅱ级高于Ⅲ级。结论　遗传因素是情感障碍和精神分裂症发病的重要因素之一 ,且患病基因可能位于X染色体上。     

家族性与散发性精神分裂症的病原学研究

目的 :研究家族性与散发性精神分裂症相关因素。方法 :采用病历记载和家属核实的方法 ,对 5 0 1例精神分裂症患者的家族史 (限于一级亲属 )、性别、发病年龄进行对比分析研究。结果 :FH +较FH -组发病年龄早 ,FH -女性组较FH +女性组及FH +、FH -男性组发病年龄晚 ,均有统计学意义 ,而FH +男性组与女性组发病年龄无差异。结论 :家族性与散发性精神分裂症在发病年龄上的性别现象为 :有阳性家族史者发病年龄早 ,家族史阴性男性较女性发病年龄早。     

Ⅰ型和Ⅱ型精神分裂症的遗传效应比较

目的：了解Ⅰ型和Ⅱ型精神分裂症间是否存在遗传效应的差异．方法：调查了精神分裂症Ⅰ型（１８６例）和Ⅱ型（９９例）患者亲属中精神疾病病的患病情况。结果：Ⅱ型组有精神疾病家族史多，一级亲属中精神分裂症的发病的发病风险率高。一级亲属的遗传率高，与Ⅰ型组比较，差异均有显著性。结论：Ⅰ型和Ⅱ型精神分裂症间存在着遗传效应差异。     

精神分裂症患病同胞的性别差异研究

目的：探讨精神分裂症患病同胞临床表现及预后的性别差异。方法：于1981年至2001年对51例精神分裂症异性患病同胞进行回顾性对照研究,其中男性25例,女性26例。对男女两组的有关情况进行比较。采用阳性与阴性症状量表（PANSS）评定精神症状。结果：男性患者病前社会功能差于女性,PANSS总分显著高于女性,阴性症状差异更为明显,住院时间男性明显多于女性。经5年随访,社会功能缺陷量表（SDSS）评定显示,男性残疾程度较女性严重,男性婚姻状况明显差于女性。结论：精神分裂症患病同胞在社会功能,精神症状等方面存在性别差异。     

An MRI study of superior temporal gyrus volume in women with schizotypal personality disorder

OBJECTIVE: An abnormal superior temporal gyrus has figured prominently in schizophrenia research, and left superior temporal gyrus volume has been shown to be smaller in male subjects with schizotypal personality disorder. This is the first structural magnetic resonance imaging study to examine a group of female subjects with schizotypal personality disorder. METHOD: The superior temporal gyrus was drawn on coronal images acquired from female subjects recruited from the community (schizotypal personality disorder group: N=21, comparison group: N=29). RESULTS: There were no gray matter volume differences in the left or right superior temporal gyrus between the subjects with schizotypal personality disorder and the comparison subjects. Within the schizotypal personality disorder group, however, there was an interaction between hemisphere and family history of mental illness. Moreover, subjects with schizotypal personality disorder did demonstrate formal thought disorder and a negative correlation between left superior temporal gyrus volume and odd speech. CONCLUSIONS: This study of female subjects with schizotypal personality disorder showed no superior temporal gyrus volume differences, but preliminary findings indicate that among female subjects with schizotypal personality disorder, there is a left-right difference in those who have a family history of mental illness relative to those who do not. These data also suggest an association between abnormal speech and left superior temporal gyrus volume, a finding similar to that found in schizophrenia. Results from this study thus clearly reinforce the importance of studying female subjects separately.     

男女儿童青少年精神分裂症患者临床特征的比较

目的:比较儿童青少年精神分裂症男性与女性患者临床特征的差异。方法:对125例男性(男性组)和133例女性(女性组)儿童青少年精神分裂症患者的年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数、简明精神病量表(BPRS)、大体评定量表(GAS)及临床疗效总评量表(CGI)评分等临床特征进行比较。结果:男性与女性患者在年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数方面比较差异无统计学意义(P均0.05)。BPRS评分中敌对性、动作迟缓、情感淡漠、缺乏活力因子分男性组高于女性组(t=2.164,t=3.317,t=2.096,t=2.230;P0.05或P0.01);幻觉、思维障碍因子分女性组高于男性组(t=3.682,t=2.987;P0.01或P0.001)。入院时GAS、CGI-SI评分及出院时CGI-GI评分两组间差异无统计学意义(P均0.05),出院时CGI-EI评分女性组高于男性组(t=2.466)、自知力评分男性组高于女性组(t=2.403),差异有统计学意义(P均0.05)。结论:男性儿童青少年精神分裂症患者的临床特征以情感淡漠、缺乏活力等阴性症状为主,女性则以幻觉、思维障碍等阳性症状更突出;女性临床疗效优于男性。     

晚发性和早发性精神分裂症的遗传差异

目的：了解晚发性和早发性精神分裂症在遗传效应上的差异。方法：调查精神分裂症晚发组和早发组患者亲属中精神病的患病情况。结果：早发组有精神病家族史多,一级亲属中精神分裂症的发病风险率高,一级亲属的遗传率高,与晚发组比较,有明显的差异性。结论：晚发性和早发性精神分裂症间有遗传效应上的差异。     

精神分裂症患者攻击行为的相关因素分析

目的:探讨精神分裂症患者攻击行为的相关因素。方法:调查住院精神分裂症患者185例,分为攻击组(n=31)和非攻击组(n=154),采用SPSS13.0分析相关因素。结果:诊断分型、简明精神病评定量表(BPRS)总分及因子分、婚姻状态等两组差异有显著性。结论:诊断分型等是预测攻击行为的一个方法;家庭史、既往攻击史、入院态度是攻击行为的危险因素;婚姻是保护因素。     

儿童期与青少年期起病的精神分裂症临床比较

目的：了解儿童期起病和青少年期起病精神分裂症临床特征及差异。方法：儿童期起病26例（儿童组），青少年期起病68例（青少年组）;采用自编临床资料调查表对患者家属进行调查;采用病前适应性量表（PAS）对患者病前心理社会适应情况进行评定。结果：两组患者父母的生育年龄比较差异无显著性（t=-0.519，P〉0.05）;青少年组出现思维内容障碍64例（94.1%）明显高于儿童组18例（69.2%），两组比较差异有显著性（χ^2=10.461，P〈0.05）;儿童组男性在同伴关系、学校适应性及PAS总分上均显著高于同组的女性（P均〈0.05）;青少年组男性在学业成绩上显著高于同组女性（t=2.548，P〈0.05）。儿童组男性学校适应能力较青少年组男性显著为差（P〈0.05）。有家族史的两组男性在同伴关系上差异有显著性（t=3.873，P〈0.05）。结论：早发型精神分裂症中思维内容障碍、心理社会适应不良与起病年龄有关。     

Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis

OBJECTIVE: To examine and compare the adult outcome in a representative sample of hospitalized adolescent-onset psychoses including occupational and social aspects. METHOD: A total of 81 patients with a first episode of early-onset psychosis (before age 19 years) presenting to the University Hospital of Lund, Sweden, between 1982 and 1993 were followed up an average of 10.5 years (range 5.1-18.2) after admission. Initial diagnosis was assessed from records and consisted of DSM-IV schizophrenia (n = 32), schizoaffective disorder (n = 7), bipolar disorder (n = 25), and major depressive disorder with psychotic features (n = 17). All could be traced and assigned a major outcome group. RESULTS: Early-onset schizophrenia spectrum disorder suffered a chronic course with a poor outcome in 79% of the cases, while early-onset affective psychosis in 74% showed a good or intermediate outcome. The poor outcome (26%) in the affective group was connected to mental retardation in 7% and to progression to a schizoaffective disorder in 12%. A particularly severe outcome was seen for schizophrenia spectrum patients with a family history of nonaffective psychosis. CONCLUSIONS: Early-onset schizophrenia spectrum disorder showed a severe course while affective psychoses had a much more benign functional outcome.     

流浪精神分裂症患者临床特征研究

目的:比较流浪与非流浪精神分裂症患者的临床特征的差异。方法:对200例流浪精神分裂症患者(流浪组)和200例非流浪精神分裂症患者(非流浪组)临床特征及简明精神病评定量表(BPRS)进行比较分析。结果:流浪精神分裂症患者中伴躯体疾病和既往有精神病史患者显著性高于非流浪精神分裂症患者;流浪精神分裂症患者中BPRS总分、思维障碍、兴奋冲动、敌对猜疑显著性高于非流浪精神分裂症患者。结论:流浪精神分裂症患者的临床特征与非流浪精神病患者有明显差异。     

Suicide risk in relation to socioeconomic,demographic, psychiatric,and familial factors: a national register-based study of all suicides in Denmark, 1981-1997

OBJECTIVE: Suicide risk was addressed in relation to the joint effect of factors regarding family structure, socioeconomics, demographics, mental illness, and family history of suicide and mental illness, as well as gender differences in risk factors. METHOD: Data were drawn from four national Danish longitudinal registers. Subjects were all 21,169 persons who committed suicide in 1981-1997 and 423,128 live comparison subjects matched for age, gender, and calendar time of suicide by using a nested case-control design. The effect of risk factors was estimated through conditional logistic regression. The interaction of gender with the risk factors was examined by using the log likelihood ratio test. The population attributable risk was calculated. RESULTS: Of the risk factors examined in the study, a history of hospitalization for psychiatric disorder was associated with the highest odds ratio and the highest attributable risk for suicide. Cohabiting or single marital status, unemployment, low income, retirement, disability, sickness-related absence from work, and a family history of suicide and/or psychiatric disorders were also significant risk factors for suicide. Moreover, these factors had different effects in male and female subjects. A psychiatric disorder was more likely to increase suicide risk in female than in male subjects. Being single was associated with higher suicide risk in male subjects, and having a young child with lower suicide risk in female subjects. Unemployment and low income had stronger effects on suicide in male subjects. Living in an urban area was associated with higher suicide risk in female subjects and a lower risk in male subjects. A family history of suicide raised suicide risk slightly more in female than in male subjects. CONCLUSIONS: Suicide risk is strongly associated with mental illness, unemployment, low income, marital status, and family history of suicide. The effect of most risk factors differs significantly by gender.