CONCEPTUALIZING BORDERLINE SYNDROME OF CHILDHOOD AND CHILDHOOD SCHIZOPHRENIA AS A DEVELOPMENTAL DISORDER

Objective: This is the first attempt to define and validate criteria f or an early onset, chronic syndrome of disturbances in affect modulati on, social relatedness, and thinking. This study formulates and tests five hypotheses that follow from conceptualizing this syndrome as a de velopmental disorder. The advantages of viewing this syndrome as a dev elopmental disorder are discussed and compared with alternative formul ations such as childhood schizophrenia or borderline syndrome of child hood. Method: An inpatient cohort (26 boys, 4 girls) was ascertained u sing specific, defined criteria. Using standardized measures on retros pective chart reviews, these subjects were compared with two different inpatient samples: one diagnosed with dysthymic disorder, the other w ith conduct disorder. Results: The criteria readily distinguished betw een developmentally disordered children and comparison groups. Finding s also supported the hypotheses in the predicted directions; index sub jects had earlier onset of symptoms, poorer social and overall adjustm ent, longer hospitalizations, and poorer outcomes. Conclusions: Findin gs support the validity of this developmental concept for a multiple c omplex developmental disorder and give preliminary, ''first-cut'' vali dity to these specified criteria.