Conceptualizing "borderline syndrome of childhood" and "childhood schizophrenia" as a developmental disorder.
OBJECTIVE
This is the first attempt to define and validate criteria for an early onset, chronic syndrome of disturbances in affect modulation, social relatedness, and thinking. This study formulates and tests five hypotheses that follow from conceptualizing this syndrome as a developmental disorder. The advantages of viewing this syndrome as a developmental disorder are discussed and compared with alternative formulations such as childhood schizophrenia or borderline syndrome of childhood.


METHODS
An inpatient cohort (26 boys, 4 girls) was ascertained using specific, defined criteria. Using standardized measures on retrospective chart reviews, these subjects were compared with two different inpatient samples: one diagnosed with dysthymic disorder, the other with conduct disorder.


RESULTS
The criteria readily distinguished between developmentally disordered children and comparison groups. Findings also supported the hypotheses in the predicted directions; index subjects had earlier onset of symptoms, poorer social and overall adjustment, longer hospitalizations, and poorer outcomes.


CONCLUSIONS
Findings support the validity of this developmental concept for a multiple complex developmental disorder and give preliminary, "first-cut" validity to these specified criteria.
Towbin
K E
KE
Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06510.
Dykens
E M
EM
Pearson
G S
GS
Cohen
D J
DJ
D000293:Adolescent; D001883:Borderline Personality Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010553:Personality Development; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012561:Schizophrenia, Childhood / Q000145:classification / Q000175:diagnosis* / Q000523:psychology