Premorbid speech and language impairments in childhood-onset schizophrenia: Association with risk factors

Objective: As both premorbid neurodevelopmental impairments and familiar ri sk factors for schizophrenia are prominent in childhood-onset cases (with o n set of psychosis by age 12), their relationship was examined. Method: Premorbid language, motor, and social impairments were assessed in a cohort of 49 patients with childhood-onset schizophrenia. Familiar loadin g for schizophrenia spectrum disorders, familial eye-tracking dysfunction, and obstetrical complications were assessed without knowledge of premorbid abnormalities and were compared in the patients with and without developmen tal impairments. Results: Over one-half of the patients in this group had developmental dysf unction in each domain assessed. The patients with premorbid speech and lan guage impairments had higher familial loading scores for schizophrenia spec trum disorders and more obstetrical complications, and their relatives had worse smooth-pursuit eye movements. The boys had more premorbid motor abnor malities, but early language and social impairments did not differ signific antly between genders. There were no other significant relationships betwee n premorbid social or motor abnormalities and the risk factors assessed her e. Conclusions: Premorbid developmental impairments are common in childhood-on set schizophrenia. The rates of three risk factors for schizophrenia (famil ial loading for schizophrenia spectrum disorders, familial eye-tracking dys function, and obstetrical complications) were increased for the probands wi th premorbid speech and language impairments, suggesting that the pathophys iology of schizophrenia involves the abnormal development of language-relat ed brain regions.