title: Psychotic symptoms and gray matter deficits in clinical pediatric populations.
abstract: BACKGROUND
  Neuroanatomic studies have not yet addressed how subtle phenotypic distinctions in psychosis alter the underlying brain changes, and whether there is evidence for psychosis as a dimensional construct. We explored the relationship of cortical GM thickness to psychotic phenotypes in children.
  
  
  METHODS
  Cross-sectional comparison of anatomic brain imaging between patients referred as childhood-onset schizophrenia (COS) but ruled out after a drug free inpatient observation. Groups included: patients with no evidence of psychosis (n=22) after drug free observation, patients with psychosis not otherwise specified (PNOS; total n=29) further divided into those without other axis I diagnoses (n=13) and those with other axis I comorbidities (n=16), age/sex matched COS patients (n=48), and 51 matched healthy controls. GM cortical thickness was compared between the groups, and regressed on patients' SAPS, SANS and GAS scores.
  
  
  RESULTS
  Patients with no evidence of psychosis showed no cortical GM deficits. Presence of psychosis (PNOS with or without co-morbidities) showed some areas of temporal and prefrontal deficits, more subtle compared to the extensive bilateral cortical deficits seen for COS. GAS SAPS and SANS scores showed a relationship with cortical GM thickness although it did not survive adjustment for multiple comparisons.
  
  
  CONCLUSIONS
  These results highlight the need for careful phenotypic characterization, as subtle diagnostic distinctions appear to reflect distinct underlying patterns of brain deficits. The incremental nature of cortical deficits from no psychosis to PNOS to COS may further support dimensional model for psychosis.
authors: Child Psychiatry Branch, National Institutes of Health, Building 10, Center Dr., Bethesda, MD 20892, USA. gogtayn@mail.nih.gov
authors: Nitin
authors: N
authors: Gogtay
authors: Brian
authors: B
authors: Weisinger
authors: Jennifer L
authors: JL
authors: Bakalar
authors: Reva
authors: R
authors: Stidd
authors: Oscar
authors: O
authors: Fernandez de la Vega
authors: Rachel
authors: R
authors: Miller
authors: Liv
authors: L
authors: Clasen
authors: Deanna
authors: D
authors: Greenstein
authors: Judith L
authors: JL
authors: Rapoport
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000453:epidemiology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D012561:Schizophrenia, Childhood / Q000453:epidemiology* / Q000473:pathology*