A Neurodevelopment Approach for a Transitional Model of Early Onset Schizophrenia

Abstract

In the last decades, the conceptualization of schizophrenia has dramatically changed, moving from a neurodegenerative process occurring in early adult life to a neurodevelopmental disorder starting be-fore birth, showing a variety of premorbid and prodromal symptoms and, in relatively few cases, evolving in the full-blown psychotic syndrome. High rates of co-occurring different neurodevelopmental disorders such as Autism spectrum disorder and ADHD, predating the onset of SCZ, and neurobio-logical underpinning with significant similarities, support the notion of a pan-developmental disturbance consisting of impairments in neuromotor, receptive language, social and cognitive development. Con-sidering that many SCZ risk factors may be similar to symptoms of other neurodevelopmental psychi-atric disorders, transition processes from child & adolescent to adult systems of care should include both high risk people as well as subject with other neurodevelopmental psychiatric disorders with different levels of severity. This descriptive mini-review discuss the need of innovative clinical approaches, re-considering specific diagnostic categories, stimulating a careful analysis of risk factors and promoting the appropriate use of new and safer medications.

Mental Health Literacy and Dementia

“…They show how and where their understanding is different from professionals as well as how and why it differs from culture to culture [8]. It also gives an insight into what is called transitional psychiatry and the aging process [9][10][11].…”

Brain Plasticity in Humans and Model Systems: Advances, Challenges, and Future Directions

“…It is well known that alterations in brain maturation and plasticity are linked to the emergence of neurological disorders [112][113][114][115][116][117]. In particular, schizophrenia and psychosis spectrum disorders are associated with an impacted timeline of brain maturation [29,118].…”

“…Though the precise mechanisms associated with the emergence of neurological disorders remain elusive, research in neuroimaging have started to shed some light on the problem. For instance, we know that the mis-wiring of prefrontal areas, resulting from genetic or environmental cues, act during brain development, and contribute to cognitive impairment in psychiatric disorders [112,114]. In schizophrenia, the dysfunction of local circuitry within the prefrontal cortex and its long-range connectivity is linked to aberrant maturation and connectivity [115].…”

Treatment Approaches for First Episode and Early-Phase Schizophrenia in Adolescents and Young Adults: A Delphi Consensus Report from Europe

“…[1][2][3]11,12 Compared to adult-onset schizophrenia, the diagnostic process is complex given the preceding psychopathology (also termed the clinical high-risk stage), 13,14 many ongoing physiological changes and peak time emergence of other mental disorders during this developmental age, 10 when disruption of early neurodevelopmental patterns can occur, particularly during the prenatal/perinatal period and adolescence. [15][16][17][18][19][20][21] Genetic susceptibility enhanced by environmental or chemical factors and traumatic events appears to trigger an abnormal development of some brain regions, resulting in alteration of white matter, greater loss of grey matter, excess synaptic pruning, and dysregulation of stress signalling pathways. [16][17][18][19]22 The differentiation of impairments in brain connectivity depends on the developmental period during which these triggers act, influencing disease onset and trajectory.…”