Health & Medicine - Posted by Karl Bates-Duke on Thursday, January 28, 2010 16:31 - 6 Comments    
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Signs of schizophrenia in childhood

schizophrenia

Knowing more about the early clues to schizophrenia could lead to better studies of possible cognitive interventions, says study coauthor Richard Keefe. The findings suggest that adult psychosis doesn’t just emerge fully-formed. It probably comes from a developmental process. “What we think of as adult psychiatric disorders have their roots much earlier in life,” coauthor Avshalom Caspi adds.

DUKE (US)—Children who experience cognitive difficulties may develop schizophrenia as adults, a study shows.

A team of researchers from Duke University used a long-term study of 1,000 New Zealanders born from 1972 to 1973 and found a consistent pattern of developmental difficulties that first appeared when the adults were 7 years old. The difficulties included problems with verbal reasoning, working memory, attention, and processing speed.

The article will appear in the February issue of the American Journal of Psychiatry.

“The proportion of kids who don’t score well on these tests is big, and the number of kids who develop schizophrenia is tiny,” says study coauthor Terrie Moffitt, the Knut Schmidt Nielsen professor of psychology and neuroscience.

“We looked backwards to understand more about how schizophrenia may develop.”

The research team found that by age 32, 1 percent of the study participants met the formal criteria for schizophrenia and had been hospitalized and put on antipsychotic medication. Another 2.5 percent met the diagnostic criteria for the disorder, but hadn’t received treatment.

Knowing what they know now, the researchers were able to track the progress of these cognitive deficits as the subjects went through testing at ages 3, 5, 7, 9, 11, and 13 as part of the Dunedin Multidisciplinary Health and Development Study.

“These kids are lagging behind to begin with and they continue to fall behind,” says study coauthor Richard Keefe, director of Duke’s Schizophrenia Research Group.

Keefe says the subjects’ verbal skills are initially poor, and then they develop other problems along the way, including difficulties with memory and verbal processing, key factors in learning.

For each year between the ages of 7 and 13, the children who later received a diagnosis of schizophrenia lost between 0.17 and 0.26 years in mental age when compared with the other children.

Two patterns emerged: The children who developed adult schizophrenia had early deficits in verbal and visual learning, reasoning, and conceptualization that remained with them as they grew.

They also showed slower development than their peers in processing speed, attention, visual-spatial problem-solving, and working memory.

The researchers stress that the minds of these children did grow, they just didn’t grow as well.

Adults with schizophrenia have been known to lag about 8 points behind the average person in IQ tests, but this study puts a finer point on where and how they might differ.

How or why schizophrenia later develops is still a mystery, but this new evidence provides some valuable clues, says coauthor Avshalom Caspi, the Edward M. Arnett Professor of psychology and neuroscience.

It’s possible that a child who struggles to make sense of the world becomes more socially isolated or more delusional, Caspi explains. “How does a brain that’s ill-equipped to deal with novel sensations deal with the stresses of adolescence?”

Keefe stresses that while tempting, treatment of younger patients with anti-psychotic medications is not recommended, because you would be treating 20 percent of the children to prevent only a one percent occurrence—meaning 19 percent of the children would have been treated unnecessarily.

“Of course, eventually we hope we’d be able to intervene, maybe even without drugs,” Keefe says. Knowing more about the early clues to schizophrenia could lead to better studies of possible cognitive interventions, he says.

The findings suggest that adult psychosis doesn’t just emerge fully-formed. It probably comes from a developmental process. “What we think of as adult psychiatric disorders have their roots much earlier in life,” Casper concludes.

Duke University news: www.dukenews.duke.edu

6 Comments

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DLeigh
Jan 30, 2010 13:29

During my undergraduate Psychology 100 course, I wrote a response paper about psychological disorders. I wrote about my sister and her struggle with schizophrenia. There were definite cognitive differences between her and other children. She was diagnosed with learning disorders and couldn’t concentrate at the elementary school level. As a comment on this paper, my professor insisted that children do not show symptoms in childhood that it is not until late adolescents that the illness appears. I was given a lower grade on the assignment.

It would be scary to me to think that no symptoms would appear earlier in childhood. Suddenly one day a psychotic break happens with no apparent warning signs until the actual break?

Amy Arnsten (Yale) once spoke about evidence suggesting stress pathways in the brain are linked to Schizophrenia. If these pathways are present earlier in life and it is only a stressful situation that triggers the psychotic break wouldn’t it be evident that some symptoms of the illness would appear earlier in life as well?

Brian
Jan 30, 2010 17:45

Yes, there are indeed illnesses/disorders (for this purpose only will I conflate the two) that are not evident until a traumatic experience; it should not be surprising. What your professor was likely trying to say is that the symptoms /as such/ are not evident until approximately late adolescence and thus you were given appropriate marks. Given this, though, it is of course at least in some part related to development, but that is certainly not the entirety of this illness. This article is misleading in that it does not account for other factors and makes a leap in interpretation of the data that is itself fine, I’m sure. Those with schizophrenia, it is implied here, develop it out of stresses due to being, let’s be frank, dumber than other children. Really? I can list a few who I doubt would be deemed cognitively inferior to their peers. My sub-point is to not ignore these exceptions to the authors’ interpretation of the data. In dealing with those with schizophrenia, I find that these people are quite creative and that their thoughts are everywhere. Of course it would consequently be difficult to memorize, focus on one issue, and even have difficulty with verbal ’skills’ (just think, when you’re flustered, you can be eloquent?). My line of reasoning, though, leads to some related characteristics and perhaps symptoms indeed being evident in childhood. So, the question is which set of symptoms are used in diagnosing schizophrenia? If we follow the DSM, then some symptoms /must/ be evident in childhood, just not those, and certainly not all, that are sufficient to diagnose schizophrenia (so, your professor is still correct). For instance, many who are later diagnosed with schizophrenia are not exactly social but not exactly /anti/-social. My point is this: the interpretation offered here seems shallow and ill-considered and needs to be revisited.

veronyke
Feb 15, 2010 14:42

i think it’s all true in this article…The main therapy option for patients who are suffering from this mental clinical condition is an effective medication therapy. The most common drugs that have proven to be recommended in the case of Schizophrenia belong to the class of antipsychotic medicines. A therapy with such drugs is able to reduce the symptoms that are commonly associated with this medical condition. Most medicines of this kind provide their first beneficial effects after 2 weeks of therapy.More about medications on http://24drug.com/

chaoco
Jun 5, 2010 8:08

I have schizophrenia and have tried multiple drugs and am mostly allergic to anti psychotics so my response be prerogative. I currently take 1200 lithium, flexiril for neuralgia pain tardive dyskenisia and grimace facial muscle pain, metoprolol tartrate for hypertension due to inflammation or other, and ambien for sleep terror disorder. I have constant auditory and visual hallucinations with two other personalities that try to takeover my main personality for use of my day to day body and I have found that Ambien and other hypnotic sedatives work better than lithium and all other drugs I have taken, I take ten mg ambien and if I stay awake it causes the voices to fall asleep and become much less responsive and much less hallucinatory, though it increases the persistent sexual arousal syndrome they cause as they move around but even this is less in all at its peak. If they could develop a sedative hypnotic i could take during the daytime that does not cause visual hallucinations I would take it and it would be seventy five percent effective rather than the dull twenty five percent effectiveness of lithium and other antipsychotics that do not cause (in some cases) even worse symptoms than the schizophrenia bacteria by itself without any chemical compounds at all.

chaoco
Jun 5, 2010 8:13

Most children will not tell you if they have symptoms as the schizo will act under the guise of imaginary friends, ghosts that people think are friendly, and dissassociztive amnesia such as trauma or other, this happened to me when I was four years and continued for several months then went dormant till twenty and caused more amnesia, and has been persistent since twentyfour, how convenient that it followed the timetables for schizo, frontal lobe shuts down till twenty and maybe another eason people have dormant schizo, mostly acts like a person or group of people who are slightly less intelligent than the main personality as they are bacteria or other, some may be HIB vac cause or other, but it is all things at once just like it said in its dummy books, life for dummies

Louis vuitton
Jun 23, 2010 1:32

My point is this: the interpretation offered here seems shallow and ill-considered and needs to be revisited.

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