Childhood onset diagnoses in a case series of teens at clinical high risk for psychosis.
REASONS: Schizophrenia is typically an adult neurodevelopmental disorder that has its antecedents in childhood and adolescence. Little is known about disorders "usually first diagnosed in infancy, childhood and adolescence" (e.g., childhood-onset disorders) in "prodromal" teens at heightened clinical risk for psychotic disorder.


RESULTS
Childhood-onset disorders were prevalent in putatively prodromal teens, including anxiety and disruptive disorders, attention-deficit/hyperactivity disorder (ADHD), and, surprisingly, elimination disorders. These may reflect developmental antecedents in psychotic disorders such as schizophrenia.
A case series of 9 teens (ages 13-17) identified as prodromal to psychosis were evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Childhood-onset diagnoses commonly endorsed (threshold or subthreshold) included ADHD (5/9), oppositional defiant disorder (5/9), enuresis or encopresis (4/9), conduct disorder (2/9), separation anxiety (3/9), and transient tic disorder (2/9). Enuresis was identified in 3 of the 4 older teens (ages 15-17).


CONCLUSIONS
An understanding of the childhood-onset disorders that occur in teens at risk for psychotic illnesses, such as schizophrenia, can shed light on the pathophysiology of schizophrenia and potentially inform early identification and intervention.
Mazzoni
Paola
P
Center of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, New York 10032, USA.
Kimhy
David
D
Khan
Shamir
S
Posner
Kelly
K
Maayan
Lawrence
L
Eilenberg
Mara
M
Messinger
Julie
J
Kestenbaum
Clarice
C
Corcoran
Cheryl
C
D000293:Adolescent; D017668:Age of Onset; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis; D019955:Conduct Disorder / Q000175:diagnosis; D019960:Elimination Disorders / Q000175:diagnosis; D004775:Enuresis / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis*; D012307:Risk Factors; D013981:Tic Disorders / Q000175:diagnosis