Childhood-onset schizophrenia: biological markers in relation to clinical characteristics

Javad Alaghband-Rad, National Institute of Mental Health
Susan D. Hamburger, National Institute of Mental Health
Jay N. Giedd, University of Maryland School of Medicine
Jean A. Frazier, University of Massachusetts Medical School
Judith L. Rapoport, National Institute of Mental Health

Abstract

OBJECTIVE: The purpose of this study was to examine the relationships between clinical and neurobiological measures of childhood-onset schizophrenia. It was hypothesized that there would be a more striking pattern in the rare cases with very early onset than is seen in subjects with later onset.

METHOD: Premorbid, clinical, prenatal, perinatal, and magnetic resonance imaging brain measures were examined in 29 children and adolescents who met the DSM-III-R criteria for schizophrenia with onset before age 12. Specifically, gender, premorbid adjustment, and clinical symptoms were examined in relation to cerebral volume, ventricular volume, and maternal obstetrical complications.

RESULTS: Males were more likely to have had an insidious onset than females. There was a significant negative correlation between score on the Scale for the Assessment of Negative Symptoms and total cerebral volume.

CONCLUSIONS: These neurobiological associations support the continuity of early-onset schizophrenia with the later-onset disorder; the striking association between smaller cerebral volume and negative symptoms suggests a more homogeneous or more potent neurobiological basis for very early-onset schizophrenia.