前青春期に発症した精神分裂病の臨床的考察
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概要
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There have been relatively few explorations into preadolescent schizophrenics in contradistinction with adult and childhood schizophrenics so far, to the effect that the preadolescent period is an important missing link which should fill the presesnt gap between two distinct pattern of adult and childhood schizophrenics and would thereby contribute to the problem of the relationship of schizophrenia with the development. A retrospective study on 27 cases of which onset of the illness lay between 8 and 15 years of age, namely in the period from the early budding to full bloom of the puberty changes, were performed by clinical observation, by inquiry on their enviroment and by analysis of documents. The gender ratio of the material is almost equal in contrast to the male prevalence of childhood schizophrenia. Some patients revealed certain triggering situatinos or events (12/27) and they showed better prognosis than those with no such moments. The whole material was found to be categorized into four using prominent symptomatologic features, that is,the delusional-hallucinatory, the obsessive-compulsive, the abnormal behavior and the aspontaneity-deterioration categories. The entire cases were classified into these four categories by independent two ways, i. e., by their initial symptoms during the course of the illness observed. In regard with initial symptoms, all cases of the abnormal behavior category had their onset at ages before ten years, whilst almost all delusional-hallucinatory cases (8/9) began after twelve years of age. Every categories different in initial symptom pattern tend to converge into the del usional-hallucinatory category as the time went on, excepting the obsessive-compulsive cases which had a marked tendency to remain identical throughout the entire period of observation. The prognosis of the preadolescent schizophrenics was graded into four according to the measure widely used for adult schizophrenics, namely, 1) fair, 2) good 3) poor, 4) bad (=continuous hospitalization). This scale was applied onto the 18 patients whose observation period was longer than five vears. The result was rather remarkable in that the delusional-hallucinatory category as determined by initial symptoms had a poor prognosis (the 3rd and the 4th grade in 6/7) while the aspontaneity-deterioration category showed a relatively good outcome ; these conclusions are at a variance with those in adult schizophrenia. In general, about half of the entire cases (7/18) were estimated the 1st and the 2nd grades. Considerations on the properties of preadolescent schizophrenics on the data obtained and the comparison with other reports were performed.
- 神戸大学の論文