Cannon M, Caspi A, Moffitt TE, et al. Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort

University of Wisconsin–Madison, Madison, Wisconsin, United States
Archives of General Psychiatry (Impact Factor: 14.48). 06/2002; 59(5):449-56. DOI: 10.1001/archpsyc.59.5.449
Source: PubMed


Childhood developmental abnormalities have been previously described in schizophrenia. It is not known, however, whether childhood developmental impairment is specific to schizophrenia or is merely a marker for a range of psychiatric outcomes.
A 1-year birth cohort (1972-1973) of 1037 children enrolled in the Dunedin Multidisciplinary Health and Development Study was assessed at biennial intervals between ages 3 and 11 years on emotional, behavioral, and interpersonal problems, motor and language development, and intelligence. At age 11 years, children were asked about psychotic symptoms. At age 26 years, DSM-IV diagnoses were made using the Diagnostic Interview Schedule. Study members having schizophreniform disorder (n = 36 [3.7%]) were compared with healthy controls and also with groups diagnosed as having mania (n = 20 [2%]) and nonpsychotic anxiety or depression disorders (n = 278 [28.5%]) on childhood variables.
Emotional problems and interpersonal difficulties were noted in children who later fulfilled diagnostic criteria for any of the adult psychiatric outcomes assessed. However, significant impairments in neuromotor, receptive language, and cognitive development were additionally present only among children later diagnosed as having schizophreniform disorder. Developmental impairments also predicted self-reported psychotic symptoms at age 11 years. These impairments were independent of the effects of socioeconomic, obstetric, and maternal factors.
The results provide evidence for an early-childhood, persistent, pan-developmental impairment that is specifically associated with schizophreniform disorder and that predicts psychotic symptoms in childhood and adulthood.

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    • "Such impairments include abnormal involuntary movements (Pappa & Dazzan, 2009; Walther & Strik, 2012), neurological soft signs (NSS), catatonic symptoms, psychomotor slowing, and Parkinsonian signs (Walther & Strik, 2012). Studies investigating birthand high-risk cohorts document motor impairments before the onset of schizophrenia (Cannon et al., 2002; Jones, Rodgers, Murray, & Marmot, 1994; Marcus, Hans, Lewow, Wilkinson & Burack, 1985, Marcus, Hans, Auerbach & Auerbach, 1993; McNeil, Harty, Blennow, & Cantor-Graae, 1993; Niemi, Suvisaari , Haukka, & Lonnqvist, 2005; Rosso et al., 2000; Walker, Savoie & Davis, 1994). Impaired motor skills in childhood have been categorized as a biomarker for predicting development of schizophrenia in adulthood (Erlenmeyer-Kimling et al., 2000; Niemi et al., 2005). "
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    ABSTRACT: Background: Early detection of schizophrenia risk is a critical goal in the field. Endophenotypes in children to relatives of affected individuals may contribute to this early detection. One of the lowest cost and longest theorized domains is motor development in children. Methods: A meta-analysis was conducted comparing individuals ≤21 years old with affected first-degree relatives (FDR) with (1) individuals from unaffected families (controls), or (2) individuals with FDR having other psychiatric disorders. Studies were classified by motor outcome and separate meta-analyses were performed across six correlated domains, with available N varying by domain. Results: Inclusion criteria were met by k = 23 independent studies with a total N = 18,582, and N across domains varying from 167 to 8619. The youth from affected families had delays in gross and fine motor development in infancy (k = 3, n = 167, Hedges'g = 0.644, confidence intervals (CI) = [0.328, 0.960], p < .001), walking milestones (k = 3, n = 608, g = 0.444, CI = [0.108, 0.780], p = .01), coordination (k = 8, n = 8619, g = 0.625, CI = [0.453, 0.797], p < .0001), and had more abnormal movements such as involuntary movements (k = 6, n = 8365, g = 0.291, CI = [0.041, 0.542], p = .02) compared with controls. However, not all effects survived correction for publication bias. Effects for neurological soft signs were small and not reliably different from zero (k = 4, n = 548, g = 0.238, CI = [-0.106, 0.583], p = .18). When comparing the FDR group to youth from families with other psychiatric disorders, the FDR group was distinguished by poorer gross and fine motor skills (k = 2, n = 275, g = 0.847, CI = [0.393, 1.300], p < .001). Conclusions: Motor deficits during development likely represent an endophenotype for schizophrenia, although its specificity is limited in relation to other serious mental disorders. It holds promise as a low cost domain for early risk detection, although it will have to be combined with other indicators to achieve clinically usable prediction accuracy. Impaired coordination was the most robust result with a moderate effect size and lack of heterogeneity and publication bias.
    No preview · Article · Nov 2015 · Journal of Child Psychology and Psychiatry
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    • "Higher risk of PE in early adolescence has been reported in individuals with childhood neurodevelopmental non-psychotic disorder (ND) (Khandaker et al. 2014), which is also a frequent co-morbid disorder (Jeppesen et al. 2015a). Lower intelligence quotient (IQ) is associated with schizophrenia (Woodberry et al. 2008; Khandaker et al. 2011) and may also be associated with PE in both non-clinical adult (Cannon et al. 2002; Johns et al. 2004) and child populations (Horwood et al. 2008; Polanczyk et al. 2010). However, these risk factors are to a large extent non-specific, and evidence supporting predictions as to which vulnerable individuals will develop which cluster of mental symptoms is sparse (Kounali et al. 2014). "
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    ABSTRACT: Background: Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate of any mental disorder. Method: We assessed 1630 children from the Copenhagen Child Cohort 2000 regarding PE and HyperToM at the follow-up at 11-12 years. Mental disorders were diagnosed by clinical ratings based on standardized parent-, teacher- and self-reported psychopathology. Logistic regression analyses were performed to test the correlates of PE and HyperToM, and the specificity of correlates of PE v. correlates of any Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) mental disorder. Results: Univariate analyses showed the following correlates of PE: familial psychiatric liability; parental mental illness during early child development; change in family composition; low family income; regulatory problems in infancy; onset of puberty; bullying; concurrent mental disorder; and HyperToM. When estimating the adjusted effects, only low family income, concurrent mental disorder, bullying and HyperToM remained significantly associated with PE. Further analyses of the specificity of these correlates with regard to outcome revealed that HyperToM was the only variable specifically associated with PE without concurrent mental disorder. Finally, HyperToM did not share any of the investigated precursors with PE. Conclusions: HyperToM may have a specific role in the risk trajectories of PE, being specifically associated with PE in preadolescent children, independently of other family and child risk factors associated with PE and overall psychopathology at this age.
    Full-text · Article · Sep 2015 · Psychological Medicine
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    • "The continuum of psychosis does not concern only the phenomenological similarities between the experiences laying on its extremes, but they were also associated with similar risk factors, and similar cognitive [10] [11] [12] [13] [14], emotional [15] [16] and personality traits [17] [18] [19] [20] as the clinically relevant psychotic symptoms. What is more, the recent researches showed that the psychotic – like experiences may have similar neural correlates as psychotic disorders. "

    Full-text · Article · Apr 2015 · Psychiatria polska
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