Corcos Maurice, Clervoy Patrick, Jeammet Philippe
Département de psychiatrie de l'adolescent et du jeune adulte Institut mutualiste Montsouris 75014 Paris.
Rev Prat. 2002 Jun 1;52(11):1183-90.
Childhood onset schizophrenia is very rare, but it's existence evokes a neuro-developmental hypothesis of a morbid process (genetic vulnerability and perinatal factors), affecting early cerebral development and evolving quietly until post-adolescence when the first psychotic symptoms manifest. The prodromic phase of schizophrenia consists of a constellation of non-specific symptoms, that which renders the institution of early treatment so difficult. The presence of psychotic symptoms in adolescence, even more so than in the adult, is not synonymous with schizophrenia. The appearance of an acute psychotic episode does not automatically prejudge an evolution to schizophrenia. It is the clinical investigation over several weeks that gives a diagnostic and therapeutic orientation. The existence of proven positive symptoms and the evolution of negative symptoms, despite a supportive environment and treatment, provide the best diagnostic arguments.
儿童期起病的精神分裂症非常罕见,但其存在引发了一种关于病态过程的神经发育假说(遗传易感性和围产期因素),该过程影响早期大脑发育,并悄然演变,直至青春期后期才出现首次精神病性症状。精神分裂症的前驱期由一系列非特异性症状组成,这使得早期治疗的实施非常困难。青春期出现精神病性症状,甚至比成年人出现此类症状更不能等同于精神分裂症。急性精神病性发作的出现并不必然预示会演变为精神分裂症。数周的临床调查才能提供诊断和治疗方向。尽管有支持性环境和治疗,但存在已证实的阳性症状以及阴性症状的演变,才是最佳的诊断依据。