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Neurodevelopmental Pathways in Schizophrenia.

McClellan1, McCurry

  • 1Department of Psychiatry, University of Washington, Seattle, WA

Seminars in Clinical Neuropsychiatry
|March 20, 1999
PubMed
Summary
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Early-onset schizophrenia is viewed as a neurodevelopmental disorder. Findings suggest genetic/neurological risks and environmental factors interact to cause schizophrenia and other psychotic disorders in youth.

Area of Science:

  • Child and Adolescent Psychiatry
  • Neurodevelopmental Disorders
  • Psychotic Disorders

Background:

  • Early-onset schizophrenia (EOS) is increasingly understood as a neurodevelopmental disorder.
  • Youth with psychotic disorders present complex diagnostic and etiological challenges.
  • Longitudinal studies are crucial for understanding the developmental trajectory of these conditions.

Purpose of the Study:

  • To investigate early-onset schizophrenia within a neurodevelopmental framework.
  • To characterize cognitive and premorbid functioning in youth with various psychotic disorders.
  • To explore the role of genetic and environmental factors in the etiology of these disorders.

Main Methods:

  • A 2-year longitudinal prospective study of youth diagnosed with psychotic disorders.

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  • Utilized standardized diagnostic interviews (DSM-IV, DISC-R) and neuropsychological tests (WISC-III, WCST, CVLT).
  • Gathered family and developmental history through parent interviews and chart reviews; 48 subjects recruited.

    • Main Results:

    • Schizophrenia group showed higher premorbid social withdrawal and peer relationship difficulties.
    • All groups exhibited significant cognitive impairment, prenatal/perinatal complications, and comorbid psychiatric disorders.
    • Homotypic family psychiatric history correlated with diagnosis in youth.

    Conclusions:

    • Data support a neurodevelopmental model for schizophrenia and other psychotic disorders.
    • Interactions between specific genetic/neurological risks and non-specific biological/environmental factors are implicated.
    • Early-onset psychosis in youth is associated with premorbid impairments and neurodevelopmental risk factors.