Pubertal development and onset of psychosis in childhood onset schizophrenia (original) (raw)
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Earlier Puberty as a Predictor of Later Onset of Schizophrenia in Women
American Journal of Psychiatry, 2014
Objective: The aim of this study was to determine whether puberty plays a mediating role in onset of schizophrenia. The hypothesis was that there is an inverse relation between age at puberty (menarche) and age at onset in women. Method: Competent and consenting individuals with DSM-IV-defined schizophrenia or schizoaffective disorder and their mothers underwent a 45-minute interview to ascertain age at first odd behavior, age at first psychotic symptoms, age at first hospitalization, and ages at various indices of puberty. Information about substance use, head injury, perinatal trauma, and first-degree family history of schizophrenia was also obtained. Results: In the women (N=35), the earlier the age at menarche, the later the ages at both the first psychotic symptoms and the first hospitalization. There was no significant association between puberty and onset in the men (N= 45). Other than gender, none of the examined variables played a role in the interaction of puberty and onset of illness. Conclusions: In women, early puberty (whether through hormonal or social influence) was associated with later onset of schizophrenia. This effect was not found in men; in fact, the trend was in the opposite direction.
Timing of puberty and syndromes of schizotypy: a replication☆
International Journal of Psychophysiology, 1999
The view of schizophrenia as a neurodevelopmental disorder involving an abnormality in the programmed elimination of excitatory synapses during puberty has been supported by recent neuroimaging studies suggesting disordered functional connectivity in schizophrenia. We investigated a model predicting dysfunctionally high or low synaptic density in extreme early or late maturers at puberty, respectively (Saugstad, L.found increased psychosis proneness scores in both extremes of the pubertal timing spectrum in the normal population. Here we present a replication study where N = 100 healthy adults completed a retrospective pubertal timing scale and the 'Personality Syndrome Questionnaire' measuring schizotypy syndromes. The following relationships were replicated: (1) elevated scores on scales of the total Unreality syndrome and the Ideas of Reference subscale in both maturation extremes; and (2) a trend for a positive correlation between the Withdrawal scale and the composite maturation score in males. Cognitive Unreality and Suspiciousness were higher in early than late maturing females. Social Anxiety was elevated in female extreme maturers compared with average maturers, but the opposite was found for males, where average maturers had higher scores than early or late maturers. Active syndrome findings were confined to the male subs ample with late maturing males showing higher scores on the Cognitive Failures and Odd Speech subscales than early maturers. As in the previous study, there was IT Earlier versions of this paper were presented no relationship between a global psychosis proneness scale and maturational rate. These findings support a neurodevelopmental model of psychosis-proneness and show the importance of adopting a syndromal view.
Schizophrenia With Onset in Adolescence: An 11-year Followup
Schizophrenia Bulletin, 1993
This study examined the course of illness and factors affecting it in schizophrenias with onset between the ages of 14 and 18. Noteworthy in comparison to findings from other followup studies is the higher proportion of chronic courses of illness, about 50 percent. In addition, the type of course of illness corresponds in general with the treatment status. A possible explanation for this observation is the early age of onset, at which point the patient has not yet developed a sufficient degree of social and emotional independence and maturity before developing a schizophrenic psychosis. The age of onset is also shown to be an important predictor for the overall course of illness, as in other studies.
Childhood Onset Schizophrenia: Clinical Features, Course and Outcome
Journal of Indian Association For Child and Adolescent Mental Health, 2008
Schizophrenia in children is diagnosed by using adult criteria. Based on the age of onset, patients with childhood onset schizophrenia (COS) are subdivided into those with very early onset (before age 12-14 years) and those with early onset (between 14-17 years). The prevalence of COS is reported to be 1 in 10,000 before the age of 12 years; however, there is a significant increase around puberty and early adolescence and by 18 years of age, 20% of the patients with schizophrenia will have the illness. Simple delusions and hallucinations revolving around childhood themes, language and communication deficits and flat affect have been reported in COS. Follow-up studies suggest that the outcome is generally poor to fair. Predictors of poor outcome are age of onset (<12 years), insidious onset and marked premorbid abnormalities.
Is the course of brain development in schizophrenia delayed? Evidence from onsets in adolescence
Schizophrenia research, 1999
A degree of ventricular enlargement, together with a reduction of total cortical mass and loss of asymmetry is reported in schizophrenia, but the meaning is obscure. These changes may reflect an anomaly of brain development. Brain structure was assessed on a 1.5-Tesla MRI scan in a series of 29 adolescents at the time of a first episode of schizophrenia and compared with 15 adolescents with other serious psychiatric disturbance (mostly psychotic) and 20 normal adolescent controls. The age at scan ranged between 13 and 20 years. In the adolescents with a diagnosis of schizophrenia, total brain volume increased with age in a way that differed significantly (p=0.007) from that seen in patients with other psychiatric disturbance and normal controls. Thus, brain growth, as assessed by this index, had reached a plateau in the control group by the age of 13 years, but this was not true of patients with schizophrenia. The measure that most clearly distinguished the groups (p<0.001 after ...
The British Journal of Psychiatry, 2003
Background An increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses. Aims To examine the evidence for a specific association between premorbid impairment and child- and adolescent-onset schizophrenia, and whether specific continuities exist between premorbid impairments and psychotic symptom dimensions. Method Retrospective case note study of 110 first-episode child- and adolescent-onset psychoses (age 10–17 years). DSM–III–R diagnoses derived from the OPCRIT algorithm showed 61 with schizophrenia (mean age 14.1 years) and 49 with other non-schizophrenic psychoses (mean age 14.7 years). Results Premorbid social impairment was more common in early-onset schizophrenia than in other early-onset psychoses (OR 1.9, P=0.03). Overall, impaired premorbid development, enuresis and incontinence during psychosis were specifically associated with the negative psychotic symptom dimension. Conclusions Premorbid social im...
Lessons from childhood-onset schizophrenia
Brain Research Reviews, 2000
Childhood-onset schizophrenia (with an onset of psychosis by age 12) is a rare and severe form of the disorder which is clinically and neurobiologically continuous with the adult-onset disorder. Very early onset diseases provide an opportunity to look for more salient or striking risk or etiologic factors in a possibly more homogenous patient population. For the 47 patients with very
The Onset of Schizophrenia in Adolescence: Developments from a Structural and Clinical Point of View
Open Journal of Medical Psychology, 2014
In 1899, Kraepelin identified schizophrenia as early dementia. The precocity of the onset of schizophrenia may be verified in psychotic episodes in the clinic of adolescence, which this article explores both from the point of view of psychoanalytic theory, and from the point of view of its clinic, in particular regarding the transference of the psychotic adolescent. It departs from the importance of differential diagnosis in relation to neurosis, using the guidelines of Freud about the loss of reality, then studies the contributions of Lacan in relation to that which returns from the real when not included in the symbolic. Finally, it articulates the drive theory to identify the issue of jouissance in transference.
Childhood-Onset Schizophrenia: A Followup Study
Schizophrenia Bulletin, 1994
This article is an overview of our studies of childhood-onset schizophrenia. Data are presented demonstrating that (1) the majority of the sample showed continuing schizophrenia as they progressed through adolescence; (2) there was considerable variability in outcome, defined by global adjustment scores, with 56 percent of the sample showing improvement in functioning during a 2- to 7-year followup period and