Geschlechterunterschiede bei Kindern und Jugendlichen mit schizophrener Erkrankung

Bei der vorliegenden Arbeit handelt es sich um eine prospektive Untersuchung mit retrospektiven Elementen. Die an Schizophrenie erkrankten Kinder und Jugendlichen wurden nach der stationären Aufnahme prospektiv nach einem vorher festgelegten Regime regelmäßig untersucht. Anhand des „instrument for t...

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Bibliographic Details
Main Author: el Hafid, Zoubida
Contributors: Basler, Heinz-Dieter (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2007
Online Access:PDF Full Text
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The paper on hand is a prospective investigation containing retrospective elements. After hospitalisation, children and adolescents with schizophrenia are examined prospectively on a regular basis according to a previously determined regimen. The onset of the schizophrenic disorder was established retrospectively using the “instrument for the retrospective assessment of the onset of schizophrenia“ (“IRAOS“). Target of the study was the investigation of children and adolescents with schizophrenia for gender differences with regard to numerical differences, age at onset, course of the disease, symptoms and cognitive function. All patients diagnosed with schizophrenia and hospitalised at the Marburg Mental Health Clinic for Children and Adolescents from 1 May 1991 until 30 November 1999 were investigated, after drug consumption and organical causes for the symptoms were ruled out. On admission, a comprehensive anamnesis was carried out by an expert psychiatrist for children and adolescents, together with the legal guardian. The medical history was supplemented with information from physicians’ letters, if prior contact was made with a medical or psychological institution, and the personal history was carried out together with the patients after stabilisation of their clinical status. As soon as the schizophrenic patient was seen fit, the intelligence quotient was tested according to HAWIK. During weekly interviews, the psychopathology was investigated during the course by means of the “brief psychiatric rating scale” (BPRS). The diagnosis was revised during the course when necessary and the patient excluded from the study. On the basis of the discussion quoting the corresponding literature, which supports our results, the issues and hypotheses of the study presented can be summarised as follows: (1) If the primary manifestation of schizophrenia falls before the age of 14, boys contract the disease more often than girls. If the onset of the schizophrenic disease falls beyond this age, there is no gender preference. (2) There is no gender difference with regard to age at the onset of schizophrenia, neither in association with the very early onset form nor if the disease sets in after the age of 14. (3) Among schizophrenic patients with continuous course, the percentage of males with the disease is 58%. In the very early onset group, the ratio of schizophrenic patients with continuous course is 64% and therefore higher than in the group in which the disease sets in after the age of 14. Here, the rate of schizophrenic patients with continuous course is 37% (first signs of mental disorder). (4) At the onset of the disease, there is no gender difference with regard to symp-toms. (5) Neither are there gender differences in terms of intelligence quotas as indication of cognitive function. Children and adolescents with schizophrenia have a lower IQ than the average population. Children with very early onset schizophrenia have a lower intelligence quota than adolescents who contract the disease at a later time. Overall, our results are well consistent with previous publications on this subject. We found no bibliographical references regarding symptoms and differences in cognitive function between the very early onset group and the early onset group. Since the remaining results can be regarded to be relatively representative because they are well in line with the bibliographical references, we assume that our results in terms of the two other issues mentioned above can be regarded to be representative as well. However, verification with a further study is necessary, especially because the paper is subject to certain limitations – as are almost all papers dealing with the subject of childhood schizophrenia.