Abstract
Early onset schizophrenia (EOS) is defined as that beginning in childhood or adolescence (under 16 or 17). Studies of EOS are infrequent, and comparative adult figures not always available, but tentative conclusions may be drawn. EOS is more common in males; symptomatology is often undifferentiated; frequencies of homotypic family disorder, premorbid schizotypal personality, and neurodevelopmental abnormalities high; outcome poor but only slightly worse than in adults; response to psychotropic drug treatment probably similar though not properly tested; and confusion with psychotic bipolar disorder particularly common. Onset before language is developed presents special diagnostic difficulties. There are a few reports of autistic children developing schizophrenia but this requires replication. Differences from adult schizophrenia are more marked when onset is in childhood than in adolescence but all are quantitative rather than qualitative suggesting that the disorders are the same and that there should be no separate category for children or adolescents.
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References
Andreasen, N. C. (1987). The diagnosis of schizophrenia.Schizophrenia Bulletin, 13, 25–34.
Apter, A., Bleich, A., & Tyano, S. (1987). Affective and psychotic psychopathology in hospitalized adolescents.Journal of the American Academy of Child and Adolescent Psychiatry, 27, 116–120.
Asarnow, J. R. & Ben-Meir, S. (1988). Children with schizophrenia spectrum and depressive disorders: a comparative study of premorbid adjustment, onset pattern, and severity of impairment.Journal of Child Psychology and Psychiatry, 29, 477–488.
Asarnow, J. R., Goldstein, M. J., & Ben-Meir, S. (1988). Parental communication deviance in childhood onset schizophrenia spectrum and depressive disorders.Journal of Child Psychology and Psychiatry, 29, 825–838.
Asarnow, R. F., Asarnow, J. R., & Strandburg, S. (1989). Schizophrenia: A developmental perspective. In D. Cicchetti (Ed.),Rochester symposium on developmental psychology (pp. 189–220). New York: Cambridge University Press.
Aylward, E., Walker, E., & Bettes, B., (1984). Intelligence in schizophrenia: Meta-analysis of the research.Schizophrenia Bulletin, 10, 430–459.
Bashir, M., Russell, J., & Johnson, G. (1987). Bipolar affective disorder in adolescence: A 10 year study.Australian and New Zealand Journal of Psychiatry, 21, 36–43.
Beitchman, J. H. (1985). Childhood schizophrenia: a review and comparison with adult-onset schizophrenia.Psychiatric Clinics of North America, 8, 793–814.
Bettes, B. A., & Walker, E. (1987). Positive and negative symptoms in psychotic and other psychiatrically disturbed children.Journal of Child Psychology and Psychiatry, 28, 555–567.
Cantor, S., Evans, J., Pearce, J., & Pezott-Pearce, T. (1982). Childhood schizophrenia: Present but not accounted for.American Journal of Psychiatry, 139, 758–762.
Caplan, R., Guthrie, D., Fish, B., Tanguay, P. E., & David-Lando, G. (1989). The Kiddie Formal Thought Disorder Rating Scale: Clinical assessment, reliability, and validity.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 408–416.
Caplan, R., Perdue, S., Tanguay, P. E., & Fish, B. (1990). Formal thought disorder in childho onset schizophrenia and schizotypal personality disorder.Journal of Child Psychology & Psychiatry, 31, 1103–1114.
Carlson, G. A. (1990). Child and adolescent mania: Diagnostic considerations.Journal of Child Psychology and Psychiatry, 31, 331–342.
Carpenter, W. T. (1987). Approaches to knowledge and understanding of schizophrenia.Schizophrenia Bulletin, 13, 17–24.
Cohen, L. J., Test, M. A., & Brown, R. L. (1990). Suicide and schizophrenia: Data from a prospect of community treatment study.American Journal of Psychiatry, 147, 602–607.
Eisenberg, L. (1957). The course of childhood schizophrenia.Archives of Neurology and Psychiatry, 78, 69–83.
Eggers, C. (1978). Course and prognosis in childhood schizophrenia.Journal of Autism and Childhood Schizophrenia, 8, 21–36.
Eggers, C. (1989). Schizoaffective psychoses in childhood: A follow-up study.Journal of Autism and Developmental Disorders, 19, 327–42.
Goldstein, M. J. (1987). Psychosocial issues.Schizophrenia Bulletin, 13, 157–171.
Green, W. H., Campbell, M., Hardesty, A. S., Grega, D. M. Padron-Gayol, M., Shell, J., & Erlenmeyer-Kimling, L. (1984). A comparison of schizophrenic and autistic children.Journal of the American Academy of Child Psychiatry, 23, 399–409.
Green, W. H. & Padron-Gayol, M. (1986). Schizophrenic disorder in childhood: its relationship to DSM-III criteria. In C. Shagass (Ed.),Biological psychiatry 1985 (pp. 1484–1486). Amsterdam: Elsevier.
Gudex, M., & Werry J. S. (1990). Organic and substance use disorders. In:B. Tonge, G. D. Burrows, & J. S. Werry (Eds.),Handbook of studies in child psychiatry (pp. 107–122). Amsterdam: Elsevier.
Hanson, D. R., & Gottesman, I. I. (1976). The genetics, if any, for infantile autism and childhood schizophrenia.Journal of Autism and Childhood Schizophrenia, 6, 209–234.
Jordan, K., & Prugh, D. C. (1971). Schizophreniform psychoses of childhood.American Journal of Psychiatry, 128, 323–331.
Joyce, P. R. (1984). Age of onset in bipolar affective disorder and misdiagnosis of schizophrenia.Psychological Medicine, 14, 145–149.
Kane, J. M. (1987). Treatment of schizophrenia.Schizophrenia Bulletin, 13, 171–186.
Kolvin, I. (1971). Studies in the childhood psychoses.British Journal of Psychiatry, 118, 381–419.
Kolvin, I., & Berney, T. P. (1990). Childhood schizophrenia. In B. Tonge, G. D. Burrows, & J. S. Werry (Eds.),Handbook of studies in child psychiatry (pp. 123–136). Amsterdam: Elsevier.
Kydd, R. R., & Werry, J. S. (1981). Schizophrenia in children under 16 years.Journal of Autism and Developmental Disorders, 12, 343–357.
Makita, K. (1966). The age of onset of childhood schizophrenia.Folia Psychiatrica et Neurologica Japonica, 20, 111–121.
McClellan, J. M., & Werry, J. S. (1992). Schizophrenia.Psychiatric Clinics of North America, 15, 131–148.
Meltzer, H. Y. (1987). Biological studies in schizophrenia.Schizophrenia Bulletin, 13, 93–128.
Petty, L. K., Ornitz, E. M., Michelman, J. D., & Zimmerman, E. G. (1984). Autistic children who become schizophrenic.Archives of General Psychiatry, 41, 129–135.
Prior, M., & Werry, J. S. (1986). Autism, schizophrenia and allied disorders. In H. C. Quay & J. S. Werry (Eds.),Psychopathological disorders of childhood (3rd ed., pp. 156–210). New York: Wiley.
Reid, A. H. (1989). Schizophrenia in mental retardation: Clinical features.Research in Developmental Disabilities, 10, 241–249.
Russell, A. T., Bott, L., & Sammons, C. (1989). The phenomenology of schizophrenia occurring in childhood.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 399–414.
Rutter, M. (1972). Childhood schizophrenia reconsidered.Journal of Autism and Childhood Schizophrenia, 2, 315–337.
Sharfstein, S. S., & Clark, H. W. (1978). Economics and the chronic mental patient.Schizophrenia Bulletin, 4, 399–414.
Steinberg, D. (1985). Psychotic and other severe disturbances in adolescence. In M. Rutter & L. Hersov (Eds.),Child and adolescent psychiatry: Modern approaches (pp. 567–583). Oxford, England: Blackwell.
Strober, M., Hanna, G., & McCracken, J. (1989). Bipolar disorder. In C. G. Last & M. Hersen (Eds.),Handbook of child psychiatric diagnosis (pp. 299–316). New York: Wiley.
Volkmar, F. R., Cohen, D. J., Hoshino, Y., Rende, R. D., & Paul, R. (1988). Phenomenology and classification of the childhood psychoses.Psychological Medicine, 18, 191–201.
Watkins, J. M., Asarnow, R. F., & Tanguay, P. (1988). Symptom development in childhood onset schizophrenia.Journal of Child Psychology and Psychiatry, 29, 865–878.
Werry, J. S., McClellan, J. M., & Chard, L. (1991). Childhood and adolescent schizophrenia, bipolar and schizoaffective disorders: A clinical and outcome study.Journal of the American Academy of Child and Adolescent Psychiatry, 30, 457–465.
Westermeyer, J. F., & Harrow, M., (1988). Course and outcome in schizophrenia. In M. T. Tsuang & J. S. Simpson (Eds.),Handbook of schizophrenia: Vol. 3.Nosology, epidemiology and genetics, Amsterdam: Elsevier.
Zigler, E., & Levine, J. (1981). Age on first hospitalization of schizophrenics.Journal of Abnormal Psychology, 90, 458–467.
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This review is based on one prepared for the DSM-IV Task Force but the opinions expressed here are solely those of the author.
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Werry, J.S. Child and adolescent (early onset) schizophrenia: A review in light of DSM-III-R. J Autism Dev Disord 22, 601–624 (1992). https://doi.org/10.1007/BF01046330
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DOI: https://doi.org/10.1007/BF01046330