Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States.
Child Psychiatry Branch, Intramural Research Program, National Institute of Mental Health, NIH, 10 Center Drive, Bldg. 10- Rm. 4N244, Bethesda, MD 20814, United States.
Schizophr Res. 2018 Jul;197:71-77. doi: 10.1016/j.schres.2017.10.045. Epub 2017 Nov 13.
This study investigated symptom dimensions and subgroups in the National Institute of Mental Health (NIMH) childhood-onset schizophrenia (COS) cohort and their similarities to adult-onset schizophrenia (AOS) literature.
Scores from the Scales for the Assessment of Positive and Negative Symptoms (SAPS & SANS) from 125 COS patients were assessed for fit with previously established symptom dimensions from AOS literature using confirmatory factor analysis (CFA). K-means cluster analysis of each individual's scores on the best fitting set of dimensions was used to form patient clusters, which were then compared using demographic and clinical data.
CFA showed the SAPS & SANS data was well suited to a 2-dimension solution, including positive and negative dimensions, out of five well established models. Cluster analysis identified three patient groups characterized by different dimension scores: (1) low scores on both dimensions, (2) high negative, low positive scores, and (3) high scores on both dimensions. These groups had different Full scale IQ, Children's Global Assessment Scale (CGAS) scores, ages of onset, and prevalence of some co-morbid behavior disorders (all p<3.57E-03).
Our analysis found distinct symptom-based subgroups within the NIMH COS cohort using an established AOS symptom structure. These findings confirm the heterogeneity of COS and were generally consistent with AOS literature.
本研究旨在调查美国国立精神卫生研究所(NIMH)儿童发病精神分裂症(COS)队列的症状维度和亚组及其与成人发病精神分裂症(AOS)文献的相似性。
使用确认性因子分析(CFA)评估 125 例 COS 患者的 Scales for the Assessment of Positive and Negative Symptoms(SAPS & SANS)量表评分,以评估其与 AOS 文献中先前建立的症状维度的拟合程度。使用最佳拟合维度集对每个个体的评分进行 K-均值聚类分析,以形成患者聚类,然后使用人口统计学和临床数据对这些聚类进行比较。
CFA 显示,SAPS & SANS 数据非常适合五个成熟模型中的二维解决方案,包括阳性和阴性维度。聚类分析确定了三个具有不同维度评分的患者组:(1)两个维度得分均低,(2)负性高,正性低得分,(3)两个维度得分均高。这些组在全量表智商(FSIQ)、儿童总体评估量表(CGAS)评分、发病年龄和一些共患行为障碍的患病率方面存在差异(均 p<3.57E-03)。
我们的分析使用已建立的 AOS 症状结构,在 NIMH COS 队列中发现了基于症状的不同亚组。这些发现证实了 COS 的异质性,并且总体上与 AOS 文献一致。