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  • Title: Developmental precursors of child- and adolescent-onset schizophrenia and affective psychoses: diagnostic specificity and continuity with symptom dimensions.
    Author: Hollis C.
    Journal: Br J Psychiatry; 2003 Jan; 182():37-44. PubMed ID: 12509316.
    Abstract:
    BACKGROUND: An increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses. AIMS: To examine the evidence for a specific association between premorbid impairment and child- and adolescent-onset schizophrenia, and whether specific continuities exist between premorbid impairments and psychotic symptom dimensions. METHOD: Retrospective case note study of 110 first-episode child- and adolescent-onset psychoses (age 10-17 years). DSM-III-R diagnoses derived from the OPCRIT algorithm showed 61 with schizophrenia (mean age 14.1 years) and 49 with other non-schizophrenic psychoses (mean age 14.7 years). RESULTS: Premorbid social impairment was more common in early-onset schizophrenia than in other early-onset psychoses (OR 1.9, P=0.03). Overall, impaired premorbid development, enuresis and incontinence during psychosis were specifically associated with the negative psychotic symptom dimension. CONCLUSIONS: Premorbid social impairments are more marked in child-and adolescent-onset schizophrenia than in other psychoses. There appears to be developmental continuity from premorbid impairment to negative symptoms.
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