title: Childhood-onset psychotic disorders: magnetic resonance imaging of volumetric differences in brain structure.
abstract: OBJECTIVE
  Although childhood-onset schizophrenia is rare, children with brief psychotic symptoms and prominent emotional disturbances commonly present diagnostic and treatment problems. Quantitative anatomic brain magnetic resonance images (MRIs) of a subgroup of children with psychotic disorder not otherwise specified were compared with those of children with childhood-onset schizophrenia and healthy comparison subjects.
  
  
  METHODS
  Anatomic MRIs were obtained for 71 patients (44 with childhood-onset schizophrenia and 27 with psychotic disorder not otherwise specified) and 106 healthy volunteers. Most patients had been treated with neuroleptics. Volumetric measurements for the cerebrum, anterior frontal region, lateral ventricles, corpus callosum, caudate, putamen, globus pallidus, and midsagittal thalamic area were obtained.
  
  
  RESULTS
  Patients had a smaller total cerebral volume than healthy comparison subjects. Analysis of covariance for total cerebral volume and age found that lateral ventricles were larger in both patient groups than in healthy comparison subjects and that schizophrenia patients had a smaller midsagittal thalamic area than both subjects with psychotic disorder not otherwise specified and healthy comparison subjects.
  
  
  CONCLUSIONS
  Pediatric patients with psychotic disorder not otherwise specified showed a pattern of brain volumes similar to those found in childhood-onset schizophrenia. Neither group showed a decrease in volumes of temporal lobe structures. Prospective longitudinal magnetic resonance imaging and clinical follow-up studies of both groups are currently underway to further validate the distinction between these two disorders.
authors.forename: S
authors.initials: S
authors.lastname: Kumra
authors.forename: J N
authors.initials: JN
authors.lastname: Giedd
authors.forename: A C
authors.initials: AC
authors.lastname: Vaituzis
authors.forename: L K
authors.initials: LK
authors.lastname: Jacobsen
authors.forename: K
authors.initials: K
authors.lastname: McKenna
authors.forename: J
authors.initials: J
authors.lastname: Bedwell
authors.forename: S
authors.initials: S
authors.lastname: Hamburger
authors.forename: J E
authors.initials: JE
authors.lastname: Nelson
authors.forename: M
authors.initials: M
authors.lastname: Lenane
authors.forename: J L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D000704:Analysis of Variance; D001921:Brain / Q000033:anatomy & histology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis*; D012559:Schizophrenia / Q000175:diagnosis*