Development of schizotypal symptoms following psychiatric disorders in childhood or adolescence

Abstract

It was examined how juvenile psychiatric disorders and adult schizotypal symptoms are associated. 731 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands, with mean age of 12.1 years (SD = 4.0) were reassessed at the mean age of 27.9 years (SD = 5.7) for adult schizotypal symptoms using the Schizotypal Personality Questionnaire-Revised (Vollema, Schizophr Bull 26(3):565-575, 2000). Differences between 13 juvenile DSM categories and normal controls (n = 80) on adult schizotypal total and factor scores were analyzed, using (M)ANCOVA. Pervasive developmental disorders (PDD), attention deficit hyperactivity disorders (ADHD), deferred diagnosis, sexual and gender identity disorders and depressive disorders had higher SPQ total scores when compared to normal controls (p < 0.001). Higher levels of disorganized schizotypal symptoms were found for PDD, ADHD, and deferred diagnosis (p < 0.001). The same diagnostic groups showed higher level of negative schizotypal symptoms, which was likewise true for sexual and gender identity disorders, depressive disorders, disruptive disorders, and the category of 'Other conditions that may be a focus of clinical attention' (p < 0.001). No differences with normal controls were found for adult positive schizotypal symptoms (p < 0.110). The current findings are suggestive of the idea that psychiatric disorders in childhood or adolescence are a more general expression of a liability to schizophrenia spectrum pathology in future life. In addition, specific patterns of adult schizotypal symptomatology are associated with different types of juvenile psychiatric disorder.

Multiscale characterization of cortical signatures in positive and negative schizotypy: A worldwide ENIGMA study

“…In addition, unique associations emerged between positive schizotypy and 22q11DS-psychosis, and between negative schizotypy and ASD. These findings are consistent with psychometric studies showing common but also distinct relationships of positive and negative schizotypy with subclinical and clinical symptoms of neurodevelopmental conditions 9,10,14–17 . An ADHD diagnosis during adolescence was found to predict higher total and negative schizotypy later in life 14 , and associations between higher ADHD features and positive schizotypy have been observed in relatives of individuals with schizophrenia 72,73 and in healthy individuals 74,75 .…”

“…These findings are consistent with psychometric studies showing common but also distinct relationships of positive and negative schizotypy with subclinical and clinical symptoms of neurodevelopmental conditions 9,10,14-17 . An ADHD diagnosis during adolescence was found to predict higher total and negative schizotypy later in life 14 , and associations between higher ADHD features and positive schizotypy have been observed in relatives of individuals with schizophrenia 72,73 and in healthy individuals 74,75 . Studies of 22q11DS individuals consistently reported elevated positive schizotypy scores 9,16,76 , mirroring the well-established increased risk of developing schizophrenia in this population 77 .…”

“…Both dimensions are linked to the schizophrenia spectrum and also intersect with neurodevelopmental disorders including autism spectrum disorder (ASD), attentiondeficit/hyperactivity disorder (ADHD), and 22q11.2 deletion syndrome (22q11DS). Individuals with ASD, ADHD, and 22q11DS tend to show high schizotypal traits [9][10][11][12][13] , and ADHD in childhood/adolescence is predictive of higher schizotypal traits in adulthood 14 . In addition, more specific associations between negative schizotypy and ASD 11,13,15 and positive schizotypy and 22q11DS 16,17 have been reported.…”

Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning

“…Whether genetic markers associated with autism and psychosis are diametrical opposites remains open to debate. There is ample evidence, however, that etiological overlap between both conditions does exist, as further supported by recent studies focusing on polygenic risk for both autism and schizophrenia (Fromer et al, 2016 ; Pourcain et al, 2018 ; Velthorst et al, 2018 ), as well as the presence of rare copy-number variations in both populations (Kushima et al, 2018 ; Zarrei et al, 2019 ). In addition, given the highly heritable nature of both ASD and PD, it is reasonable to expect a higher co-occurrence of subclinical traits of both dimensions in unaffected relatives of either patient population.…”

“…Recent efforts have therefore focused more on dimensional rather than categorical approaches, under the assumption that both conditions represent extremes on a continuum of symptomatic severity, and that even isolated or low-intensity traits may affect clinical outcomes. Such studies have provided further evidence that autistic and psychotic traits co-occur at an elevated behavioral level in clinical samples (Barneveld et al, 2011;De Crescenzo et al, 2019;Esterberg, Trotman, Brasfield, Compton, & Walker, 2008;Fagel et al, 2013;Kincaid et al, 2017;Ziermans, Swaab, Stockmann, de Bruin, & van Rijn, 2017). From a cognitive and functional perspective, it is also well established that both ASD and PD are characterized by (partially) overlapping impairments compared to typical healthy comparisons, particularly in the social domain (Martinez et al, 2017;Pinkham et al, 2019;Sasson et al, 2007Sasson et al, , 2011Sasson et al, , 2016Velthorst et al, 2018).…”