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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Schizophrenia in children is an uncommon disorder with devastating effects. Study of the efficacy of treatment with neuroleptics in children with schizophrenia is only now beginning, and there are limited studies on the effectiveness of novel neuroleptics on the positive and negative symptoms of schizophrenia in children. Four patients with schizophrenia, aged 12 to 17 years, were treated with risperidone (4 to 5 mg/day), a 5-HT2/D2 receptor blocking agent, to determine its effectiveness. Three patients had substantial improvement in their negative symptoms without side effects.
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PMID:Case study: risperidone in children and adolescents with schizophrenia. 759 66

This article presents results of a 42-year long-term followup of 44 patients (19 males, 25 females) with childhood-onset schizophrenia. Age at onset ranged from 6 to 14 years (mean =11.8 years). The patients and their first-degree relatives were interviewed in 1994, 27 years after the first followup, by the same investigator with the Present-State Examination (PSE) and the Disability Assessment Schedule. The clinical records were analyzed with the Instrument for the Retrospective Assessment of Onset of Schizophrenia and with sections of the PSE. The cases were rediagnosed according to DSM-III-R, based on longitudinal data obtained between onset and the first hospital admission. Although cumulative prevalence is earlier in females than in males, no gender differences exist in average age at onset. An acute onset was significantly more frequent after 12 years of age. An early age at onset was correlated with high social disability scores. Of the patients, 25 percent were completely, 25 percent partially, and 50 percent were poorly remitted at the second followup. None of the patients with chronic onset remitted completely. The results are discussed with respect to epidemiology, gender differences, and etiological hypotheses of childhood schizophrenia.
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PMID:The long-term course of childhood-onset schizophrenia: a 42-year followup. 905 Jan 17

Clozapine is increasingly being used for clinical indications in addition to treatment-resistant schizophrenia; this article reviews the relevant literature. The first section reassesses the risks associated with clozapine treatment, particularly agranulocytosis. The next section discusses its use for schizophrenia in patients who are treatment resistant, not treatment resistant, and intolerant of traditional drug treatments. Subsequent sections address its use in mood disorders, neurologic conditions, comorbid substance abuse, aggressive behavior, and childhood schizophrenia. Each includes the initial rationale for the use of clozapine in the disorder, a critical evaluation of the relevant literature, and theories as to why clozapine's unique pharmacodynamic profile may be efficacious for the specific condition. This body of literature suggests clozapine may be an effective treatment for a wide range of disorders.
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PMID:The expanding indications for clozapine. 926 69

Until only very recently, the occurrence of schizophrenia in childhood and early adolescence had been largely neglected. Improved diagnostic formulations have resulted in clarification of the boundaries between childhood schizophrenia, other psychotic disorders, and pervasive developmental disorder. The study of schizophrenia in childhood or adolescence provides a unique opportunity to examine illness characteristics in the absence of the confounds of substance abuse illness, chronicity, and medication effects. Additionally, current etiopathologic models of schizophrenia can be tested in this patient subgroup.
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PMID:Child and adolescent schizophrenia. 955 90

Sixty inpatients, aged 7 to 15 years, with obsessive-compulsive disorders (OCD) have been examined. The inclusion criteria comprised diagnostic ICD-10 criteria for OCD (F42), schizophrenia childhood type (F20.83) and neurotic-like schizophrenia (F21.3). Patients with organic CNS disorder signs and marked somatic pathology were excluded from the study. According to clinical features of the disease and its course (disease progressiveness), three OCD types have been determined: OCD in the structure of affective and neurotic-like spectra disorders (type 1); OCD in the structure of paranoid spectrum disorders (type 2); OCD in the structure of states with prevail of "acquired" affective and negative disorders (type 3). Consideration of OCD types in childhood schizophrenia and the disease course allows to predict severity of negative changes and remissions that facilitates an adequate determination of the patients' adaptive potential.
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PMID:[The state with the predominance of obsessive-compulsive disorders in the structure of childhood onset schizophrenia]. 1200 74

This paper reviews the concept and recent studies on childhood and adolescent psychoses with special reference to schizophrenia. After a short historical introduction, the definition, classification, and epidemiology of child- and adolescent-onset psychoses are described, pointing out that some early-onset psychotic states seem to be related to schizophrenia (such as infantile catatonia) and others not (such as desintegrative disorder). The frequency of childhood schizophrenia is less than 1 in 10,000 children, but there is a remarkable increase in frequency between 13 and 18 years of age. Currently, schizophrenia is diagnosed according to ICD-10 and DSM-IV criteria. The differential diagnosis includes autism, desintegrative disorder, multiplex complex developmental disorder (MCDD) respectively multiple developmental impairment (MDI), affective psychoses, Asperger syndrome, drug-induced psychosis and psychotic states caused by organic disorders. With regard to etiology, there is strong evidence for the importance of genetic factors and for neurointegrative deficits preceding the onset of the disorder. Treatment is based upon a multimodal approach including antipsychotic medication (mainly by atypical neuroleptics), psychotherapeutic measures, family-oriented measures, and specific measures of rehabilitation applied in about 30% of the patients after completion of inpatient treatment. The long-term course of childhood- and adolescent-onset schizophrenia is worse than in adulthood schizophrenia, and the patients with manifestation of the disorder below the age of 14 have a very poor prognosis.
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PMID:Schizophrenia and related disorders in children and adolescents. 1635 6

Diagnosing schizophrenia in children is difficult, especially in the early stages. A possible explanation is that our knowledge of symptoms is insufficient. Moreover, there are no specific classification systems for diagnosing childhood schizophrenia. A seven year-old boy presented with symptoms resulting in differential diagnostic considerations of attention deficit/hyperactivity disorder or a behavioural or emotional disorder. The boy had auditory hallucinations, was socially dysfunctional and had emotional contact disturbances, leading to the schizophrenia diagnosis.
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PMID:[Schizophrenia in a seven year-old boy]. 1843 77

Schizophrenia is a disorder characterized by delay in neurodevelopment and by a central disorder of recognition (i.e. with generalized cognitive deficit). Connectivity impairments in the areas of the social brain and cerebellum are the "messenger" of abnormal CNS development in schizophrenia. Processes of neuronal reorganization in cortical and subcortical structures, aberrant forms of pruning, sprouting, and myelinization may play a major role in the pathogenesis of a schizophrenic breakdown. Models of neuroplasticity during adolescence can be connected with models of neurodevelopmental vulnerability and models of neurotoxicity to form an integrated approach in order to better understand premorbid adjustment, onset, and course of schizophrenia. The loss of plasticity and aberrant myelinization lead to a deterioration in cognitive functions, social dysfunction and, in individuals with specific genetic vulnerability, to expression of schizophrenia. This article discusses brain development in relation to the diagnosis of schizophrenia and the basic symptoms of childhood schizophrenia (with early and very early onset) and of adolescent schizophrenia.
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PMID:Schizophrenia in childhood and adolescence. 1911 96

This review will focus on the treatment and prevention of schizophrenia in children and adolescents. Neurodevelopmental theories suggest that loss of gray matter and defective synaptic function are major etiological factors in this disease. The efficacy of current antipsychotic medications has been discussed, however, these drugs produce serious side effects and may adversely affect the developing brain. We propose a novel therapeutic approach, termed neuroenhancement, that aims to promote neuronal survival and optimize neuronal function through the use of drugs. The goal is to enhance glucose metabolism in the brain, which would support higher functional activity in neurons and provide neuroprotection. Future drug development for the treatment of childhood schizophrenia should focus more on optimization of neuronal function rather than tranquilization and symptomatic relief.
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PMID:Neuronal glucose metabolism and schizophrenia: therapeutic prospects? 1981 Aug 45

Schizophrenia in childhood is rare (point prevalence <1/10,000 before the age of 12) and most often has insidious onset, severe clinical presentation and adverse course and outcome. The incidence of schizophrenia rises dramatically in adolescence, and its prevalence is estimated at 0.23% in the age between 13 and 18 years. The findings from clinical, neuroimaging, neuropsychological and neurobiological studies support that there is a substantial continuity between childhood, adolescent and adult schizophrenia, despite developmental differences. For this reason, the DSM-IV and ICD-10 criteria for schizophrenia are valid for all age spectrums, but their application in earlier ages is difficult, and the particular developmental characteristics of each developmental phase should be taken into consideration. The differential diagnosis of childhood and adolescent schizophrenia, especially from pervasive developmental disorders, affective disorders with psychotic features and some forms of atypical psychosis, poses similar difficulties. The clinical picture is characterized predominantly by auditory hallucinations, delusions which are less complex than in adults, and flat or inappropriate affect. Formal thought disorder and disorganized behavior are common. Premorbid neurodevelopmental impairments, including language, motor and social deficits, are more frequent and more pronounced in persons that will later on develop schizophrenia during childhood or adolescence, compared to adulthood. Furthermore, the emergence of prodromal symptoms, prior to the main psychotic symptoms, is common. The onset of the main psychotic symptoms is usually insidious, and delay in diagnosis and treatment is common, with adverse consequences on the course and outcome of the disorder. The onset of overt psychosis is characterized by a marked deterioration from previous level of functioning in the vast majority of children and adolescents, and an adverse course and outcome is reported in approximately 50-60% of cases. Compared to adult schizophrenia, childhood schizophrenia manifests higher familial predisposition and possibly greater genetic loading. Some of the susceptibility genes that have been detected in adult schizophrenia have also been replicated in childhood schizophrenia studies. Neuroimaging studies in childhood schizophrenia provide evidence for progressive structural brain abnormalities. Patients with childhood onset schizophrenia manifest significant progressive reduction of gray matter volume during adolescence, to a much greater extent than the gray matter reduction normally expected due to brain development in adolescence, which seems to be linked with the reorganization ("pruning') of neural synapses. The convergent data from schizophrenia studies in children, adolescents and adults provide support for the prevailing modern neurodevelopmental theories for the aetiopathogenesis of schizophrenia. The management of schizophrenia in children and adolescents should be based on a multimodal therapeutic plan, including drug therapy and individual psychotherapy, along with family, social and educational interventions.
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PMID:[Schizophrenia in children and adolescents: relevance and differentiation from adult schizophrenia]. 2279 77


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