Predictive factors in early onset schizophrenia

Abstract

Schizophrenia is a neurodevelopmental disorder, characterized by impairment in reasoning, affectivity and social relationships. Although the diagnosis of schizophrenia in children and adolescents has been challenged for many years, at present childhood-onset schizophrenia is considered and accepted as a clinical and biological continuum with the adult-onset disorder. The present study aimed to evaluate the influence of biological (psychiatric family history, perinatal factors), and socio-demographic factors (area of residence, gender) on the age at onset and severity of symptomatology in children and adolescent with schizophrenia. The data were collected from 2016 to 2019 and included 148 children and adolescents with schizophrenia. Data were analysed with statistical software (IBM SPSS 22, JASP and JAMOVI, Linear Regression Model, χ² tests, t-test, U-test). A positive familial history for psychiatric diseases was an important risk factor both for an early onset and for the severity of symptoms. Urbanicity was another studied risk factor, 61% of patients being from urban areas; no statistically significant correlations between urbanicity and age at onset and severity of symptoms were identified. There was no statistically significant gender difference in terms of age at onset and severity of symptoms. Moreover, no statistically significant correlations were found between perinatal factors and age at onset and severity of symptoms. Positive psychiatric family history showed a statistically significant influence on age at onset and symptoms severity in children and adolescent schizophrenia; no statistical significant impact on the aforementioned schizophrenia aspects was observed for urbanicity, gender or perinatal factors.

Diagnosis stability and outcome of psychotic episodes in a Romanian group of children and adolescents

“…[18] The outcome and prognosis of psychotic disorders were correlated with the presence and severity of developmental disorders, some studies suggesting that the presence and severity of these developmental deficits may actually be a premorbid phenotype for VEOS or EOS. [19,31] There is also a statistically significant relationship between the young age of onset of the disorder and the number of relapses and the number of hospitalizations in adult psychiatry, but also between the family psychiatric history and the number of relapses and the number of hospitalizations in adult psychiatry (P < .05).…”

“…[18] The outcome and prognosis of psychotic disorders were correlated with the presence and severity of developmental disorders, some studies suggesting that the presence and severity of these developmental deficits may actually be a premorbid phenotype for VEOS or EOS. [19,31]…”

Urbanization and psychosis: an update of recent evidence

“…Urbanicity alone has been associated with the risk of schizophrenia [21,26], re-hospitalization risk [27], and greater odds of reporting positive psychotic symptoms [23]. Urbanicity was also found to have no effect on age at onset and severity of psychotic symptoms in children and adolescents [28].…”

Efficacy, Tolerability, and Safety of Toludesvenlafaxine for the Treatment of Major Depressive Disorder—A Narrative Review

“…Norepinephrine is considered a key element in the pathogenesis of MDD because locus coeruleus is the major anatomical target for monoaminergic antidepressants; a rapid decrease in the catecholamine level in the CNS has been associated with relapses of MDD; the mechanisms of the inhibition of monoamine oxidase, antagonism of presynaptic norepinephrine receptors, and inhibition of norepinephrine reuptake from the synaptic cleft increase the catecholamine neurotransmission and improve the depressive symptoms; and norepinephrine deficits have been related to the onset of low energy, inattention, executive dysfunction, and decreased alertness [ 20 , 21 , 22 , 23 ]. Dopamine neurotransmission dysfunctions are considered responsible for core symptoms of depression, e.g., anhedonia and cognitive deficits; translational and clinical studies demonstrate deficits of the dopaminergic system in depression; and antidepressants enhancing dopaminergic transmission improved symptoms of energy, pleasure, and interest in MDD patients [ 24 , 25 , 26 , 27 ].…”