Schizophrenia in Children and Adolescents
Publisher: University | ISBN: 0521794285 | edition 2001 | PDF | 328 pages | 2,2 mb
Although schizophrenia is very difficult to diagnose in the young, early treatment is now thought to improve outcome. Recent research suggests that early onset schizophrenia has developmental precursors, making it difficult to distinguish from a number of other developmental disorders. In this timely book, an international team of psychiatrists, psychotherapists, and psychologists give an up-to-date review of the latest findings in the diagnosis andtreatment of schizophrenia in children and adolescents. It gives a comprehensive account of the current state of knowledge and the therapeutic options available to clinicians. The authors examine the disorder from developmental and clinical perspectives, focusing on diagnosis, etiology, therapy, and rehabilitation. This volume is essential reading for all mental health professionals who treat young people with schizophrenia.
Contents
List of contributors page xi
Preface xiii
1 Childhood psychosis and schizophrenia: a historical review 1
The late William Ll. Parry-Jones
Introduction 1
Historiography of schizophrenia 1
Psychotic juveniles in asylums 11
Premorbid characteristics and borderline disorder 12
Epidemiology 12
Theories of causation 13
Treatment and outcome 14
Conclusions 16
References 17
2 Definition and classification 24
Helmut Remschmidt
Introduction 24
Early descriptions 24
General criteria for the classification of psychotic disorders in children
and adolescents 26
Psychotic disorders in childhood and adolescence and their relation to
schizophrenia 28
The concept of positive and negative schizophrenia in children and
adolescents 30
Premorbid characteristics 32
Classification according to ICD-10 33
Classification according to DSM-IV 37
Conclusions 39
References 39
3 Epidemiology of early onset schizophrenia 43
Christopher Gillberg
Introduction 43
Childhood autism 44
Asperger syndrome 44
Disintegrative disorder and Rett syndrome variants 46
Landau–Kleffner syndrome and the syndrome of electrical status
epilepticus during sleep 46
Very early onset schizophrenia (12 years or under) 47
Adolescent onset schizophrenia (13–19 years of age) 51
Conclusions 54
References 54
4 Childhood schizophrenia: developmental aspects 60
Fred R. Volkmar
Introduction 60
Clinical features of childhood onset schizophrenia 63
Developmental issues in differential diagnosis 73
Summary and directions for further research 74
References 75
5 Diagnosis and differential diagnosis 82
Chris Hollis
Introduction 82
Historical background: an evolving diagnostic construct 84
Recent conceptual developments 86
Principles of clinical epidemiology: tools to estimate the usefulness of
diagnostic criteria 88
Diagnostic criteria: DSM-IV and ICD-10 91
Assessment: the pursuit of reliability 94
Diagnostic validity 97
Developmental variability: symptoms and associated features 100
The influence of age and cognition on symptom assessment 101
Are there continuities between premorbid developmental impairments
and psychotic symptoms? 103
Differential diagnosis 103
Is there continuity between the MDI syndrome and schizophrenia? 105
The differential diagnosis of psychotic symptoms in children and
adolescents 106
Differential diagnoses 107
Prevention and detection of ‘at risk’ or prodromal states 109
Conclusions 112
References 113
6 Genetic aspects 119
Jane ScourÞeldand Peter McGufÞn
Introduction 119
Defining the phenotype 119
Markers of vulnerability and childhood precursors 120
Genetic epidemiology 121
Type of inheritance 127
Molecular genetics 127
Conclusions 131
References 131
7 Neurobehavioral perspective 135
Robert F. Asarnow and Canan Karatekin
Introduction 135
Precursors of psychotic symptoms in schizophrenic children 136
Studies of cognitive/neuropsychological functioning 139
Link of cognitive impairment to formal thought disorder (FTD) and
discourse skills 151
Studies of event-related potentials (ERPs) 153
Neurobiology 156
Neurodevelopmental model 159
References 161
8 Psychosocial factors: the social context of child and adolescent onset
schizophrenia 168
Joan R. Asarnow, Martha C. Tompson and the late Michael J. Goldstein
Introduction 168
Schizophrenia in adolescence: psychosocial functioning and
developmental progressions 168
Follow-up studies 169
Premorbid adjustment and predictors of outcome 170
Family stress 171
Treatment strategies for schizophrenia in adolescents 173
The psychosocial treatment of adolescents with schizophrenia 181
Importance of early intervention 183
Conclusions 186
References 187
9 Treatment and rehabilitation 192
Helmut Remschmidt, Matthias Martin, Klaus Hennighausen and Eberhard Schulz
Neuroleptic (antipsychotic) agents and their properties 192
Electroconvulsive treatment (ECT) 228
Psychotherapeutic measures (see also Chapter 8) 232
Family oriented measures (see also Chapter 8) 240
Specific measures of rehabilitation 244
A comprehensive treatment and rehabilitation program 252
References 256
10 Course and prognosis 268
Sally Nicola Merry and John Scott Werry
Introduction 268
Selection of studies 272
Organization of the review 273
Premorbid adjustment 276
Onset 277
Course 280
Outcome 282
Factors affecting outcome 287
Summary and conclusions 293
References 294
Index 298
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