Alaghband-Rad J, McKenna K, Gordon C T, Albus K E, Hamburger S D, Rumsey J M, Frazier J A, Lenane M C, Rapoport J L
Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Oct;34(10):1273-83. doi: 10.1097/00004583-199510000-00012.
To review the premorbid histories of 23 children meeting DSM-III-R criteria for schizophrenia with onset before age 12 years and to compare these with childhood data of later-onset schizophrenics.
Premorbid features up to 1 year before onset of first psychotic symptoms were rated from hospital and clinic records, clinical interviews, rating scales, and tests.
In keeping with previous studies, specific developmental disabilities and transient early symptoms of autism, particularly motor stereotypies, were common. Comparison with the childhood of later-onset schizophrenics showed greater delay in language development, and more premorbid speech and language disorders, learning disorders, and disruptive behavior disorders. (Sixty percent had received or were estimated to meet criteria for one or more clinical diagnoses.)
Childhood-onset schizophrenia may represent a more malignant form of the disorder, although selection and ascertainment bias cannot be ruled out. The presence of prepsychotic language difficulties focuses attention on the importance of early temporal and frontal lobe development; early transient motor stereotypies suggest developmental basal ganglia abnormalities and extend previous findings seen in the childhood of later-onset patients.
回顾23名符合精神分裂症DSM-III-R标准且发病年龄在12岁之前的儿童的病前史，并将其与晚发性精神分裂症患者的儿童期数据进行比较。
从医院和诊所记录、临床访谈、评定量表及测试中，对首次出现精神病性症状前1年内的病前特征进行评定。
与先前研究一致，特定发育障碍以及自闭症的短暂早期症状，尤其是运动刻板行为很常见。与晚发性精神分裂症患者的童年期相比，早发性精神分裂症患者在语言发育方面延迟更明显，病前言语和语言障碍、学习障碍及破坏性行为障碍更多见。（60%的患者已接受或据估计符合一种或多种临床诊断标准。）
儿童期起病的精神分裂症可能代表该疾病更严重的一种形式，尽管不能排除选择和确诊偏倚。精神病性症状出现前的语言困难提示早期颞叶和额叶发育的重要性；早期短暂的运动刻板行为提示发育性基底神经节异常，并扩展了先前在晚发性患者童年期观察到的结果。
