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Infant predictors of the longitudinal course of schizophrenic development
Insights
Infant neurointegrative disorders, termed pandysmaturation (PDM), predict later schizophrenia and schizotypal disorder. Early PDM symptoms indicate a need for research into infant dysfunction mechanisms for primary prevention.
Area of Science:
- Developmental Psychology
- Psychiatry
- Neuroscience
Background:
- Longitudinal study initiated in 1952 to investigate early predictors of schizophrenia.
- Focus on neurointegrative disorders in infancy as potential vulnerability markers.
Purpose of the Study:
- To test the hypothesis that specific infant neurointegrative disorders predict later schizophrenia and schizotypal disorder.
- To examine the relationship between early developmental markers and adult psychopathology.
Main Methods:
- Studied 12 offspring of mothers with schizophrenia and 12 controls from similar low SES backgrounds.
- Assessed neurointegrative disorder severity ('pandysmaturation' - PDM) using Gesell tests and growth measures from birth to 2 years.
- Conducted follow-up examinations at 10, 15, and 20/22 years with blind psychopathology evaluations.
Main Results:
- PDM severity significantly correlated with maternal schizophrenia, not obstetrical complications, SES, sex, or ethnicity.
- PDM severity predicted psychopathology severity at age 10.
- Of seven subjects with PDM who developed schizophrenia or schizotypal personality disorder, six required extensive treatment, and four remain severely impaired.
Conclusions:
- Infant pandysmaturation is a significant predictor of vulnerability to schizophrenia and schizotypal disorder.
- Early social-affective and perceptual deficits observed in infancy precede later schizophrenia symptoms.
- Primary prevention of schizophrenia necessitates research into the underlying mechanisms of infant neurodevelopmental dysfunctions.
Abstract:
This study was begun in 1952 to test the hypothesis that specific neurointegrative disorders in infancy predict vulnerability to later schizophrenia and schizotypal disorder. Twelve offspring of chronic schizophrenic mothers and 12 controls from similar low socioeconomic status (SES) backgrounds have been studied since their births in 1952-53 and 1959-60. The infants were ranked according to the severity of their neurointegrative disorder, or "pandysmaturation" (PDM), based on analysis of Gesell tests and physical growth measures repeated 10 times between birth and 2 years. Twenty-three subjects (96 percent) completed all 10-, 15- and 20/22-year followup examinations. PDM was significantly related to maternal schizophrenia but not to obstetrical complications, SES, sex, or ethnic background. The severity of PDM was significantly related to the blind evaluations of the severity of psychopathology at 10 years. One 26-year risk subject has been chronically schizophrenic since age 17. The author, nonblind, provisionally diagnosed six other risk subjects as schizotypal or paranoid personality. All seven had PDM; six required 6 to 18+ years of treatment; four with "negative" symptoms remain severely impaired. All six sick subjects had severe social-affective symptoms by 3-6 years of age; four had perceptual deficits by 2 years. Some social-affective, cognitive, academic, and vocational impairments included in the "negative" symptoms and "process" traits of schizophrenia had antecedents before 2 years of age. Primary prevention requires research into the mechanisms underlying these dysfunctions in infancy.