Lessons from childhood-onset schizophrenia

Childhood-onset schizophrenia (with an onset of psychosis by age 12) is a r are and severe form of the disorder which is clinically and neurobiological ly continuous with the adult-onset disorder. Very early onset diseases prov ide an opportunity to look for more salient or striking risk or etiologic f actors in a possibly more homogenous patient population. For the 47 patient s with very early onset schizophrenia studied to date, there were more seve re premorbid neurodevelopmental abnormalities, more cytogenetic anomalies, and potentially greater family histories of schizophrenia and associated sp ectrum disorders than later onset cases. There was no evidence for relative ly increased obstetrical complications or environmental stress. These data, while preliminary, suggest a very early age of onset of schizophrenia may be secondary to greater genetic vulnerability. It is anticipated that futur e genetic studies of these patients may provide important etiologic informa tion. (C) 2000 Published by Elsevier Science B.V. All rights reserved.