Childhood-Onset Schizophrenia: History of the Concept and Recent Studies

Abstract

Schizophrenic disorders in childhood are rare: 0.1-1 percent of all schizophrenic disorders manifest themselves before age 10, and 4 percent before age 15. There is, however, a remarkable increase in schizophrenia during adolescence. Age and developmental stage also influence symptoms, course, and outcome. The evidence for a male preponderance in the very early-onset group (< 14) does not apply for adolescents over age 14. The presence of positive and negative precursor symptoms can be demonstrated in child and adolescent schizophrenia before the first clinical manifestation leading to inpatient treatment. With regard to pharmacologic treatment, atypical neuroleptics such as clozapine can be used successfully. As to outcome, schizophrenic psychoses with early manifestation have a poor prognosis. The patients' premorbid personality also seems to be of great importance: A poor prognosis can be found in patients who were cognitively impaired, shy, introverted, and withdrawn before the beginning of their psychotic state.

Imaging as a tool in exploring the neurodevelopment and genetics of schizophrenia

“…By doing so, it attempts to explain why frank schizophrenia is extremely rare in childhood 38 , but the incidence increases rapidly after the age of 13 39 . It also incorporates the evidence from the epidemiological study of Jones et al 25 {199A), discussed earlier, that individuals who later developed schizophrenia, showed increasing developmental deviance with age and progressively more marked cognitive impairment through late childhood and into early adolescence.…”

Large CAG/CTG repeats are associated with childhood-onset schizophrenia

“…8,9 COS has an insidious onset with pre-existing personality abnormalities, premorbid social impairment and symptoms including thought blocking, delusions and hallucinations (mostly auditory). While a high male to female ratio has been reported in some series, 10 equal male and female ratios are seen in others. 5 It is generally accepted that COS is an early onset variant of the adult disorder with similarities seen in brain abnormalities, smooth pursuit eye movements, autonomic physiology, and clinical symptomology.…”

“…The RED reaction is as previously described 38,39 using a (CTG) 10 oligonucleotide which produces a repeat size representation at 30 nucleotide intervals. Briefly, amplified products were separated on a 6% denaturing polyacrylamide gel, blotted to Hybond-N™ membrane, UV-crosslinked, and hybridized with a 3Ј-32 P-labeled (CAG) 10 oligonucleotide.…”

“…Briefly, amplified products were separated on a 6% denaturing polyacrylamide gel, blotted to Hybond-N™ membrane, UV-crosslinked, and hybridized with a 3Ј-32 P-labeled (CAG) 10 oligonucleotide. The membrane was exposed to film for 24-36 h and the largest ligation products for each sample were identified.…”

“…PCR products were heat denatured in 50% formamide for 5 min before separation on a 6% denaturing polyacrylamide/6 M urea gel. DNA from the polyacrylamide gel was transferred by capillary blotting onto Hybond-N™ membrane for 2 h. Following UV immobilization, the membranes were hybridized to a (CAG) 10 oligonucleotide and autoradiographed for 0.5-12 h.…”