Developmental precursors of child- and adolescent-onset schizophrenia and affective psychoses: diagnostic specificity and continuity with symptom dimensions.
BACKGROUND
An increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses.


OBJECTIVE
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.


METHODS
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.
Hollis
Chris
C
Section of Developmental Psychiatry, Division of Psychiatry, University of Nottingham, E Floor, South Block, Queen's Medical Centre, UK. Chris.hollis@nottingham.ac.uk
D000293:Adolescent; D000341:Affective Disorders, Psychotic / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D017668:Age of Onset; D002648:Child; D002658:Developmental Disabilities / Q000150:complications*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000209:etiology*; D012565:Schizophrenic Psychology; D014549:Urinary Incontinence / Q000150:complications / Q000523:psychology