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Epidemiología de la esquizofrenia. El modelo de enfermedad de la esquizofrenia a la luz del conocimiento epidemiológico actual

Published online by Cambridge University Press:  12 May 2020

H. Häfner
H. Häfner*
Affiliation:
Unidad de Investigación de la Esquizofrenia, Instituto Central de Salud Mental, J 5, D-68159Mannheim, Alemania
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Resumen

En un intento de actualizar la epidemiología de la esquizofrenia, se señala que la esquizofrenia parece producirse con los mismos síntomas nucleares y casi con la misma frecuencia en todos los países y culturas estudiados. Estudios metodológicamente sólidos no han producido datos en favor de una tendencia secular de riesgo mórbido. El genotipo de esquizofrenia se expresa como psicosis, trastornos de la personalidad y trastornos no específicos o prescinde de manifestaciones psicopatológicas. En la mayoría de los casos, están presentes anomalías cerebrales menores. El Estudio Británico del Desarrollo Infantil mostró que se producen antecedentes conductuales, cognitivos, emocionales y neuromotores en 50% dedos casos, lo que de este modo apunta a un trastorno del desarrollo del cerebro, muy probablemente no específico a la esquizofrenia, ya que se encuentra también en muchos otros trastornos mentales. Un examen del curso temprano oculto de la esquizofrenia reveló una diferencia sexual significativa en la edad de comienzo y una fase prodrómica de unos 3 a 4 años en todos los casos. Un estudio con control de casos mostró que es sobre todo durante este curso temprano antes de la primera admisión cuando surge la desventaja social en la esquizofrenia. En la prefase, una falta de ascenso social relacionada con la enfermedad desempeña un papel mayor que los pasos de descenso social. El curso social temprano difiere entre los sexos sobre todo debido a un comienzo más temprano del trastorno en los varones. Las variables de enfermedad verdadera, es decir, los síntomas nucleares y el tipo de curso, no muestran diferencias esenciales entre varones y mujeres. Estos resultados indican que la esquizofrenia es uno de los infrecuentes patrones uniformes de respuesta del cerebro, que pueden ser desencadenados por un gran número de causas o favorecidos por factores de riesgo no específicos. Se discutirá en este contexto el efecto protector de los estrógenos.

Keywords

epidemiología de la esquizofreniahipótesis de los estrógenostendencias seculares de incidencia de la esquizofreniadiferencias de género en esquizofreniaantecedentes de la esquizofreniagripe y esquizofrenia
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 2 , Issue 6 , December 1995 , pp. 370 - 382
Copyright
Copyright © European Psychiatric Association 1995

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