title: Childhood-onset schizophrenia: the challenge of diagnosis.
abstract: During the past two decades, the Child Psychiatry Branch at the National Institute of Mental Health has conducted a longitudinal study (including long-term prospective follow-up) of childhood-onset schizophrenia, a rare form of the disorder. Critical to this research has been accurate diagnosis. Outpatient screening has accurately diagnosed 55% of the 121 childhood-onset schizophrenia patients in the study to date. However, inpatient observation including drug-free observation has proven crucial to ruling out 96 children with alternative diagnoses who had been provisionally admitted for inpatient study. Standardized clinical ratings from outpatient screening only predicted 62% of these nonschizophrenia patients. Historically, medication-free observation was standard clinical care for difficult and unusual patients; this should be employed when possible in similar situations.
authors.affiliation: Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892-1600, USA. gochmanp@mail.nih.gov
authors.forename: Peter
authors.initials: P
authors.lastname: Gochman
authors.forename: Rachel
authors.initials: R
authors.lastname: Miller
authors.forename: Judith L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D002648:Child; D006801:Humans; D011569:Psychiatric Status Rating Scales; D012561:Schizophrenia, Childhood / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology