CHILDHOOD-ONSET SCHIZOPHRENIA - THE SEVERITY OF PREMORBID COURSE

Objective: To review the premorbid histories of 23 children meeting DS M-III-R criteria for schizophrenia with onset before age 12 years and to compare these with childhood data of later-onset schizophrenics. Me thod: Premorbid features up to 1 year before onset of first psychotic symptoms were rated from hospital and clinic records, clinical intervi ews, rating scales, and tests. Results: In keeping with previous studi es, specific developmental disabilities and transient early symptoms o f autism, particularly motor stereotypies, were common. Comparison wit h the childhood of later-onset schizophrenics showed greater delay in language development, and more premorbid speech and language disorders , learning disorders, and disruptive behavior disorders. (Sixty percen t had received or were estimated to meet criteria for one or more clin ical diagnoses.) Conclusions: Childhood-onset schizophrenia may repres ent a more malignant form of the disorder, although selection and asce rtainment bias cannot be ruled out. The presence of prepsychotic langu age difficulties focuses attention on the importance of early temporal and frontal lobe development; early transient motor stereotypies sugg est developmental basal ganglia abnormalities and extend previous find ings seen in the childhood of later-onset patients.