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Oades, R. D., (2001).
Early onset schizophrenia, risk and the selective aspect of perception.
World Journal of Biological Psychiatry, 2, 98..
Most risk factors are not specific for early-onset schizophrenia (EOS),
but the illness may show a distinct pattern of development for interrelated
features.
In the Essen adolescent cohort (4) (53
subjects followed up 15y after mean onset at 15y-of-age) non-specific
features included complications at birth, cluster A personality disorders
in close relatives, and social isolation and solitary play on 6-12 year-olds.
Other typical EOS characters included a poor premorbid social adjustment,
gradual and insidious onset, male gender and predominant negative symptoms.
Although a separate cohort of 44 subjects with a mean onset at 13y did
not show a predominant male gender or gradual onset, a subgroup with
psychosis onset in childhood (< 11y) were largely male with a gradual
begin to the illness. An analysis of their premorbid features gave 4
dimensions that reflect aspects of their "isolation" (1).
It is proposed to model poor premorbid selective perceptual processes
with the psychophysiological measure of deviance detection / mismatch
negativity, MMN, (outside world) with poor integration in the internal
world (iterative frontal-temporal lobe dialogue). MMN is reduced in
adolescent schizophrenia (2): here, frontal
and temporal lobe MMN dipole sources are described along with the first
evidence of a shift in early-onset patients (3)
.
Early abnormalities in these attention-related processes may underlie
the poor development of adaptive social responses and have their origins
in the early developmental history and family environment of EOS patients.
1. Eggers C, & Bunk D, (1997). The long-term
course of childhood-onset schizophrenia: a 42-year follow-up. Schizophr.
Bull., 23, 105-117.
2. Oades
RD, et al., (1997). Impaired attention-dependent augmentation
of MMN in nonparanoid vs. paranoid schizophrenic patients: a comparison
with obsessive.compulsive disorder and healthy subjects Biol. Psychiat.,
41, 1196-1210.
3. Oades
RD, et al., (2001). Sources
of prefrontal activity for auditory working memory (MMN): evidence for
an impaired fronto-temporal lobe dialogue in schizophrenia. Eighth
International Congress: Schizophrenia Research, [Latebreaking
data], Whistler, B.C., Canada
4. Röpcke
B, Oades RD, & Eggers C, (2000). Predictors for the 15-year
outcome of schizophrenia with an early-onset in adolescence. Schizophr.
Res., 41, 79.
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