Looking for childhood schizophrenia: case series of false positives.
Extensive experience with the diagnosis of childhood-onset schizophrenia indicates a high rate of false positives. Most mislabeled patients have chronic disabling, affective, or behavioral disorders. The authors report the cases of three children who passed stringent initial childhood-onset schizophrenia "screens" but had no chronic psychotic disorder. For two, the European literature yielded more fitting diagnoses: psychosis not otherwise specified (e.g., reactive or psychogenic psychosis, paranoid schizophrenia), single episode in full remission (e.g., anxiety psychosis), and factitious disorder (DSM-IV 300.16). These cases illustrate that transient psychotic illnesses can be misdiagnosed as childhood-onset schizophrenia. Proper identification can prevent years of inappropriate therapies.
Stayer
Catherine
C
Child Psychiatry Branch, NIMH, Bethesda, MD 20892-1600, USA.
Sporn
Alexandra
A
Gogtay
Nitin
N
Tossell
Julia
J
Lenane
Marge
M
Gochman
Peter
P
Rapoport
Judith L
JL
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002667:Child Reactive Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology