School performance as a premorbid marker for schizophrenia: a twin study

Area of Science:

• Psychiatry
• Developmental Psychology
• Genetics

Background:

• Schizophrenia onset is often preceded by developmental abnormalities.
• Early detection of schizophrenia vulnerability is crucial for intervention.

Purpose of the Study:

• To investigate early developmental markers of schizophrenia.
• To determine the age of developmental divergence in individuals with schizophrenia.

Main Methods:

• Twin study design analyzing monozygotic (MZ) and dizygotic (DZ) pairs.
• Cox regression analysis to identify predictors of developmental divergence.
• Assessment of school performance and behavioral development.

Main Results:

• Developmental divergence in school performance occurred approximately 7.5 years earlier in twins with schizophrenia (at age 12).
• This divergence preceded psychosis onset by about 10 years.
• Underperformance at school is a potential early sign of schizophrenia vulnerability.

Conclusions:

• Cognitive symptoms, indicated by school underperformance, may be the first prodromal signs of schizophrenia.
• Puberty is a critical period for the manifestation of early schizophrenia symptoms.
• School performance can serve as an indicator for latent schizophrenia vulnerability.