Minor physical anomalies and craniofacial measures in patients with treatment-resistant schizophrenia

Abstract

These findings suggest that certain MPAs and craniofacial features may serve as useful markers for identifying TRS at early stages of the illness.

A trend toward smaller optical angles and medial‐ocular distance in schizophrenia spectrum, but not in bipolar and major depressive disorders

“…As a group, MPAs include subtle malformations in the craniofacial region and limbs, such as hypertelorism, low‐set ears, single palmar crease, curved fifth digit, and measurements of head circumference, maximum skull length, and skull base width that are outside of expected ranges. A recent study in patients with SCZ showed that treatment‐resistant patients could be characterized by a lower facial width and an increased lower facial height (Lin et al, ), indicating a potential clinical application of MPAs.…”

Predictors of treatment resistant schizophrenia: a systematic review of prospective observational studies

“…The neurodevelopmental theory of schizophrenia proposes that disrupted normal development, in utero or early infancy, leads to deficits in psychophysiological and neurological functioning in childhood or early adolescence, and eventually to prodromal or diagnostic symptoms of schizophrenia (Jablensky et al, 2017;Murray et al, 2017). Previous research has linked characteristics of abnormal development with TRS; higher rates of minor physical anomalies (Lin et al, 2015), more neurological soft signs (de Bartolomeis et al, 2018), poor verbal intelligence and fluency (Kravariti et al, 2018), and poor verbal memory (Joober et al, 2002;de Bartolomeis et al, 2013). None of the studies in this review included variables measuring physiology during development or cognition at the first episode.…”

Improving risk assessment and familial aggregation of age at onset in schizophrenia using minor physical anomalies and craniofacial measures

“…[54] EOS also tends to be more treatment-resistant, [34] and may reflect a more severe form of the disorder associated with a greater genetic predisposition than AOS. [55] In the current study, all MPA-based models showed greater predictive validity for EOS than AOS, and familial aggregation was higher in first-degree relatives of EOS patients, supporting a neurodevelopmental model where childhood/adolescent-onset schizophrenia may represent a more malignant disorder caused by more severe in utero neurodevelopmental disruption (as reflected by MPAs) due to greater genetic susceptibility.…”

“…The qualitatively measured MPAs and quantitatively measured craniofacial features compiled from the Waldrop scale and other previous scales were measured as described. [34] The scale for qualitative measurement of MPAs was based on that developed by Ismail et al and included 41 items. The morphological anomalies examined were located in 6 different body regions: head, eyes, ears, mouth, hand, and feet.…”

“…[33] Past studies have reported that EOS is associated with a poorer prognosis and resistance to treatment. [28,34] Association between EOS and poor outcomes such as social withdrawal, suicide, symptom severity, and negative cognitive impacts have been reported. [35–37] Early symptoms such as social withdrawal can seriously affect a young patient's academic career and social cognition, leading to negative developmental outcomes in adulthood.…”