Schizophrenia early-onset

The anxiety disorders are common and surprisingly disabling conditions. Studies on the health economics of generalized anxiety disorder, panic disorder, social anxiety disorders and obsessive compulsive disorder document the cost to the individual and to society. Attention has focused on the major psychiatric disorders such as depression, schizophrenia and the dementias. Studies suggest that many anxiety disorders are of early onset and too often chronic they are quite common and impose a heavy burden on society. More studies will be needed to discern the fine grain in the survey material and to identify more precisely the location and type of societal costs. These factors will vary from country to country, from district to district, between men and women and between various age groups. 

Epidemiologic data show that 10% to 30% of patients with schizophrenia develop their first psychotic symptoms prior to their eighteenth birthday. Onset between puberty and age of 18 is sometimes classified as early-onset schizophrenia (EOS) or intermediate onset schizophrenia, and those presenting with symptoms before puberty are classified as very early-onset... 

Although childhood cases are rare (McKenna et ah, 1994), schizophrenia has been identified in children since its earliest descriptions. Despite this, the nosological status of schizophrenia in children was controversial for many years, and the Diagnostic and Statistical Manual of Mental Disorders, 2nd ed. (DSM-II) category childhood schizophrenia included other psychotic disorders in children as well as autistic disorder, limiting the usefulness of early studies. The landmark studies by Kolvin (1971), however, clearly differentiated schizophrenia with onset in childhood from pervasive developmental disorders. 

Genetic factors are important in the pathogenesis of schizophrenia (Karayiorgou and Gogos, 1997), and the notion that such factors may be more salient in very early onset-cases fueled two classic family studies of childhood-onset cases (Kallmann and Roth, 1956 Kelvin et al., 1971). 

Blinded scoring of the birth records of 36 patients with COS and 35 sibling controls found no significant differences between the groups (Nicolson et ah, 1999c). Moreover, the rate of complications in the early-onset patients of the NIMH study was similar to that seen in adult-onset patients. These preliminary results, as well as the work of others (Frangou, 1999), suggest that, while obstetric complications may play a role in the development of schizophrenia in some patients, they are not more salient in childhood-onset cases. 

Patients with adult-onset schizophrenia have been shown to have subtle but demonstrable impairments in premorbid language as well as in motor and social development (Davies et ah, 1998), and a poor outcome in schizophrenia is correlated with more pronounced early developmental abnormalities. Several independent studies have found that very early-onset schizophrenia is associated with similar but more pronounced abnormalities (Watkins et ah, 1988 Alaghband-Rad et ah, 1995 Holhs, 1995). 

Emerging evidence suggests that patients with a very early onset of schizophrenia have greater levels of both early and later neurodevelopmental abnormalities. Environmental factors are not increased, while genetic... 

Frangou, S. (1999) The Maudsley early onset schizophrenia study abnormal genes, abnormal brains, abnormal families. Biol Psychiatry 45 12S. 

Sowell, E.R., Levitt, J., Thompson, P.M., Holmes, C.J., Blanton, R.E., Kornsand, D.S., Caplan, R., McCracken, J., Asarnow, R., and Toga, A.W (2000). Brain abnormalities observed in early onset schizophrenia spectrum disorder observed with statistical parametric mapping of structural magnetic resonance images. Am J Psychiatry 157 1475-1484. 

According to Werry (1992), we can distinguish between early-onset schizophrenia (EOS) beginning in... 

Until the publication of Kolvin (1971), the disorders now subsumed under the label of autism spectrum disorders (Wing, 1996) or developmental pervasive disorders (American Psychiatric Association [APA], 1994) were referred to as childhood schizophrenia (Bender, 1969). Kolvin demonstrated different age-of-onset patterns between autism and EOS, which was the beginning of the notion that these disorders are separate nosological entities. Early-onset schizophrenia can be... 

Gillberg, C. (2001) Epidemiology of early onset schizophrenia. In Remschmidt, H., ed. Schizophrenia in Children and Adolescents. Cambridge UK Cambridge University Press, pp. 43-59. 

Mandoki, M. (1997) Olanzapine in the treatment of early onset schizophrenia in children and adolescents. Biol Psychiatry 35(Suppl 7S) S22. 

Remschmidt, H. (2002) Early-onset schizophrenia as a progressive deteriorating disorder evidence from child psychiatry / Neural Transm 109 101-117. 

Schulz, E., Fleischhaker, C., Clement, H.-W., and Remschmidt, H. (1997) Blood biogenic amines during clozapine treatment of early-onset schizophrenia. / Neural Transm 104 1077-1089. 

Werry, J.S. (1992) Child and adolescent (early onset) schizophrenia a review in light of DSM-III-R. / Autism Dev Dis 22 601-624. 

Schizophrenia is one of most serious, debilitating mental illness as its strikes at some of the most advanced functions of the human brain. It affects about 1% of the population, regardless of economical and cultural differences. Psychotic symptoms usually begin in late adolescence or early adulthood. Because of its chronic nature, severity and early onset, schizophrenia is an expensive illness, especially in industrialized nations where the symptoms are incompatible with the highly structured nature of the workplace and where social expectations are high. 

Rosso IM, Cannon TD, Huttunen T, Huttunen MO, Lonnqvist J, et al. 2000. Obstetric risk factors for early-onset schizophrenia in a Finnish birth cohort. Am J Psychiatry 157 801-807. 

Early-stage visual processing dysfunction also appears to be a trait rather than a state marker, because for instance, PI deficits are found in early-onset schizophrenia (Haenschel et al., 2007) as well as in first-episode patients (Yeap et al., 2008b) and are unrelated to chronicity of illness (Yeap et al., 2008a). 

Kumra S, Ashtari M, McMeniman M, et al. 2004. Reduced frontal white matter integrity in early-onset schizophrenia A preliminary study. Biol Psychiatry 55 1138-1145. 

The specificity of HG volume changes to schizophrenia is supported by parallel measurements in patients with affective psychosis or mania, where decreased HG volume was not found (Hirayasu et al., 2000 Kasai et al., 2003b McCarley et al., 2002 Salisbury et al., 2007). It is undetermined whether the volume change in schizophrenia precedes the onset of psychosis. Although some studies found a decreased volume at early onset of schizophrenia (Hirayasu et al., 2000 McCarley et al., 2002 Salisbury et al., 2007 Sumich et al., 2005), there is evidence that the volume deficit worsens with disease progression and drug treatment (Crespo-Facorro et al., 2004 Kasai et al., 2003b Salisbury et al., 2007). 

Matsumoto et al. (2001) 40 40 -6 -12 Early onset schizophrenia ( 16 y.o.). Rt. correlates with thought disorder and hallucinations. 

Matsumoto H, Simmons A, Williams S, Hadjulis M, Pipe R, et al. 2001. Superior temporal gyrus abnormalities in early-onset schizophrenia Similarities and differences with adult-onset schizophrenia. Am J Psychiatry 158(8) 1299-1304. 

Preliminary research has suggested efficacy in early-onset treatment-resistant schizophrenia... 

Tabulating the occurrence and degree of fetal hypoxia in past births is usually done by examining hospital records and by interviews—indirect assessment at best. But most studies agree that MRI scans of the brains of adult schizophrenics show greater brain abnormalities for those patients who apparendy experienced fetal hypoxia during gestation, and that fetal hypoxia predicts early onset schizophrenia.35... 

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