Early-onset schizophrenia as a progressive-deteriorating developmental disorder: evidence from child psychiatry

The available study findings on the course and outcome of schizophrenia beginning in childhood or adolescence can be summarized as follows. (1) Schizophrenic psychoses that arise before the age of 13 have a very poor prognosis. The disease usually continues to progress in adolescence and adulthood. It can be diagnosed with the same criteria that are used for adults. (2) Patients whose disease is of acute onset, with productive schizophrenic manifestations such as hallucinations and delusions (positive manifestations), have a better prognosis than those whose disease begins insidiously and takes an unfavorable course, with depressive states and continually worsening impairment of cognitive function. (3) The patient’s premorbid personality plays a major role. Patients who were described as socially active, intelligent, and integrated children and adolescents before they became ill have a better prognosis than those who were intellectually impaired, timid, introverted and uncommunicative before they became ill. (4) The prognosis seems to be better for patients who have no family history of schizophrenia, those whose families cooperate well, and those whose condition improves rapidly during inpatient treatment. (5) The few available studies on the course and outcome of schizophrenia beginning in childhood and early adolescence confirm that they are much worse than in adult-onset schizophrenia. (6) A 42-year longitudinal study of patients with childhood-onset schizophrenia revealed their suicide rate to be higher than that of patients with adult-onset schizophrenia. No further longitudinal studies are available to confirm this finding.

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“…We consider VEOS to be a progressively worsening developmental disorder [6,7], for the following reasons:…”

Section: Etiologymentioning

confidence: 99%

Early-Onset Schizophrenia1

Remschmidt

Theisen

2012

Neuropsychobiology

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“…Prevalence rates suggest that childhood-onset schizophrenia is reported in only approximately 0.01% of children younger than 12 years, with the incidence increasing during the teenage years (Remschmidt, 2002). However, there is growing evidence to support altered symptom profiles in cases of childhood onset, in which negative symptoms predominate initially.…”

Section: Schizophreniamentioning

confidence: 99%

Atypical and typical antipsychotics in the schools

Noggle

Dean

2009

Psychology in the Schools

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The use of antipsychotic medications within the school‐age population is rapidly increasing. Although typical antipsychotics may be used in rare cases, this influx is largely secondary to the availability of the atypical antipsychotics. Reduction of possible adverse effects and increased efficacy represent the primary basis for the atypical antipsychotics' popularity over traditional agents. Although these agents, as their name suggests, are most commonly used to alleviate positive, as well as some negative, symptoms of psychotic manifestations, empirical evidence has suggested their efficacy in the treatment of other presentations. These include bipolar disorder, Attention‐Deficit/Hyperactivity Disorder and other disruptive behavior disorders, pervasive developmental disorders, anorexia nervosa, and tic disorders. Discussion of antipsychotic agents and their use in these presentations is offered. Information on positive and negative outcomes, including school impact, is provided. © 2009 Wiley Periodicals, Inc.

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“…If so, this leaves a window of opportunity open within which the loss can be slowed or blocked completely. This seems a reasonable goal, given that schizophrenia may be associated with diminished NMDAR activity, perinatal brain injury and reduced expression of GAD67 and PV in adult brains [23][24][25].…”

Section: For Higher Power Viewsmentioning

confidence: 99%

Postnatal Expression of GAD67

et al. 2009

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N-methyl-D-aspartate receptor blockade promotes apoptosis at postnatal day 7 (P7) and is linked to loss of glutamic acid decarboxylase 67 (GAD67) expression in older animals. To more fully appreciate this relationship we must first understand how GAD67 is regulated postnatally. Thus, the brains of P7, P14 and P21 rats were examined for expression of GAD67 protein and we found that levels of this GABAergic marker increased steadily with age, such that by P21 there was as much as a 6-fold increase compared to P7 animals and a 1.5- to 2-fold increase compared to P14 animals, depending on the region sampled. At P7, GAD67 was almost exclusively detected in puncta, with very few cell bodies displaying this marker. In contrast, at P14 and especially P21, both puncta and cell bodies were robustly labeled. Our data indicate that adult-like expression of GAD67 emerges quite late in the postnatal period.

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Early-onset schizophrenia as a progressive-deteriorating developmental disorder: evidence from child psychiatry

Cited by 88 publications

References 65 publications

Early-Onset Schizophrenia1

Early-Onset Schizophrenia1

Atypical and typical antipsychotics in the schools

Postnatal Expression of GAD67

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