title: Neurobiology and phenotypic expression in early onset schizophrenia.
abstract: OBJECTIVE
  Early-onset schizophrenia (onset before adulthood) is a rare and severe form of the disorder that shows phenotypic and neurobiological continuity with adult-onset schizophrenia. Here, we provide a synthesis of keynote findings in this enriched population to understand better the neurobiology and pathophysiology of early-onset schizophrenia.
  
  
  METHODS
  A synthetic and integrative approach is applied to review studies stemming from epidemiology, phenomenology, cognition, genetics and neuroimaging data. We provide conclusions and future directions of research on early-onset schizophrenia.
  
  
  RESULTS
  Childhood and adolescent-onset schizophrenia is associated with severe clinical course, greater rates of premorbid abnormalities, poor psychosocial functioning and increased severity of brain abnormalities. Early-onset cases show similar neurobiological correlates and phenotypic deficits to adult-onset schizophrenia, but show worse long-term psychopathological outcome. Emerging technological advances have provided important insights into the genomic architecture of early-onset schizophrenia, suggesting that some genetic variations may occur more frequently and at a higher rate in young-onset than adult-onset cases.
  
  
  CONCLUSIONS
  Clinical, cognitive, genetic and imaging data suggest increased severity in early-onset schizophrenia. Studying younger-onset cases can provide useful insights into the neurobiological mechanisms of schizophrenia and the complexity of gene-environment interactions leading to the emergence of this debilitating disorder.
authors.affiliation: Child Psychiatry Branch, National Institute of Mental Health, NIH, Bethesda, Maryland, USA. drnoravyas@gmail.com
authors.forename: Nora S
authors.initials: NS
authors.lastname: Vyas
authors.forename: Neva H
authors.initials: NH
authors.lastname: Patel
authors.forename: Basant K
authors.initials: BK
authors.lastname: Puri
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002648:Child; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D018450:Disease Progression; D006801:Humans; D010641:Phenotype; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents