Do premorbid impairments predict emergent 'prodromal' symptoms in young relatives at risk for schizophrenia?
OBJECTIVE
Individuals at risk for developing schizophrenia (SZ) in the future frequently exhibit subtle behavioural and neurobiological abnormalities in their childhood. A better understanding of the role of these abnormalities in predicting later onset of 'prodromal' symptoms or psychosis may help in early identification of SZ.


METHODS
In an ongoing prospective follow-up study of young genetically at-risk relatives of patients with SZ, we studied the prevalence of problems in premorbid social adjustment and childhood psychopathology and examined their relationship with the presence and progression of 'prodromal' symptoms of SZ.


RESULTS
Growth curve analyses showed that 'prodromal' symptoms, as measured by the Scale of 'Prodromal' Symptoms, increased during follow-up. Premorbid maladjustment and childhood behavioural disturbances were cross-sectionally correlated broadly with 'prodromal' symptomatology scores. Longitudinal analyses revealed that behavioural disturbances, but not childhood maladjustment at baseline, significantly predicted increases in 'prodromal' symptomatology during the 2-year study period.


CONCLUSIONS
Premorbid behavioural disturbance and maladjustment may predict the later emergence of 'prodromal' symptoms. 'Prodromal' symptoms in young at-risk relatives may define a subgroup worthy of follow-up into the age of risk for psychosis in order to cost-effectively characterize the predictors of psychotic symptoms and SZ.
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA. mkeshava@bidmc.harvard.edu
Matcheri S
MS
Keshavan
Shaun M
SM
Eack
Debra M
DM
Montrose
Michelle M
MM
Abela
Srihari S
SS
Bangalore
Vaibhav A
VA
Diwadkar
Konasale M R
KM
Prasad
D000293:Adolescent; D001526:Behavioral Symptoms / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D055815:Young Adult