Year: 2015
Type: dissertation
Study design: Observational Study
Abstract: The onset of schizophrenia before the age of 18 is commonly categorized as early onset schizophrenia. It accounts for less than 4% of all cases of schizophrenia, the prevalence of which is about 1% worldwide. Premorbid abnormalities seem to be very typical, and prognosis is often poor. Besides the negative and positive symptoms, severe neurocognitive deficits also occur. Schizophrenia and pervasive developmental disorders share a common history. From 1970 onwards these disorders have been regarded as separate conditions. These disorders have different ages of onset as well as developmental courses. Nevertheless, the clinical symptoms as well as the results of genetic and neuroimaging studies overlap. The participants in this thesis were adolescent schizophrenia patients (n = 18; 7 males, 11 females). The mean age of the participants at recruitment was 15.6 years (studies I-III) and at the time of psychological assessment 16.2 years (study IV). Study IV also included 15 adolescents with PDD without psychotic disorder (n = 15; 7 males, 8 females). Their mean age at recruitment was 16.1 years. All participants had a primary IQ over 70. Study I of this thesis assessed the possible comorbidity of early onset schizophrenia and pervasive developmental disorders. We found that a total of 44% of adolescents with schizophrenia had some pervasive developmental disorder already in childhood. However, most of the adolescents had a correct comorbid diagnosis until the onset of psychotic symptoms and the diagnosis of schizophrenia. Study II evaluated the number and nature of catatonic features among adolescents with schizophrenia. A further comparison was made of the nature and numbers of those features between adolescents suffering from schizophrenia alone and those schizophrenia patients with comorbid pervasive developmental disorder. All adolescents with schizophrenia presented many lifetime catatonic features. Adolescents with schizophrenia and comorbid pervasive developmental disorder had an earlier onset of catatonic features, more catatonic features and a greater variety of catatonic features compared to schizophrenia patients without comorbidity. Study III aimed to assess the developmental skills of adolescents with schizophrenia. All of the adolescents with schizophrenia exhibited some developmental delays. Adolescents with schizophrenia and comorbid pervasive developmental disorders exhibited more delays in developmental skills than did those schizophrenia adolescents without comorbidity. Study IV investigated neurocognition and social cognition between adolescents suffering from schizophrenia alone, those schizophrenia patients with comorbid pervasive developmental disorder and adolescents with pervasive developmental disorder only. The profiles of the neurocognitive abilities and disabilities between these three groups differed. The adolescents with schizophrenia and comorbid pervasive developmental disorder did not have more severe problems than the other two groups. The comorbid group displayed a combination of the visual strengths those are typical for PDDs and the deficits in processing speed associated with schizophrenia. These study findings showed that among adolescents with early onset schizophrenia is a subgroup of adolescents with comorbid pervasive developmental disorder. The symptoms of these adolescents seem to be more severe, and this subgroup should be taken into account in psychiatric services and rehabilitation.
Source: Työväentutkimus Vuosikirja
Author: Petra Waris
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2129549522