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Schizophrenia (SZ) and bipolar disorder (BD) may originate in neurodevelopmental issues. Childhood developmental problems, like psychomotor delays and adjustment issues, are more common in SZ than BD, indicating a potential neurodevelopmental link.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Developmental Psychology

Background:

  • Schizophrenia (SZ) has established neurodevelopmental origins.
  • Bipolar disorder (BD) has less consistent evidence regarding neurodevelopmental links.
  • Premorbid and early developmental milestones are key areas of investigation for both disorders.

Purpose of the Study:

  • To systematically review studies on neurodevelopmental origins of schizophrenia and bipolar disorder.
  • To compare premorbid and early developmental characteristics between SZ and BD patients.
  • To identify specific developmental markers associated with increased risk for SZ and BD.

Main Methods:

  • Systematic review of 30 studies (8 prospective, 15 retrospective, 7 registry-based) identified from 619 PubMed abstracts.
  • Focus on premorbid adjustment, functionality, and early developmental milestones.
  • Comparison of developmental trajectories between SZ and BD, considering onset and psychotic status.

Main Results:

  • Psychomotor and general adjustment problems in childhood are more pronounced in individuals later diagnosed with SZ compared to BD.
  • Cognitive impairment shows a linear risk trend for SZ and a U-shaped trend for BD.
  • Social isolation, visuoperceptual/reading anomalies, and pervasive developmental disorders are associated with increased risk for SZ and BD, particularly in individuals with normal intelligence.

Conclusions:

  • While isolated developmental markers have low predictive risk, a significant proportion of SZ patients and a minority of BD patients exhibit premorbid childhood abnormalities.
  • Further research is needed to compare SZ and BD, especially differentiating psychotic and non-psychotic bipolar cases.
  • Investigating rare genetic variants and alternative etiologies like immunological disorders is crucial for cases lacking clear neurodevelopmental markers.