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In “Very Early and Early Onset Schizophrenia Spectrum Disorders: Diagnostic Challenge,” Unti, Moisa, Burlea, et al. (2015) offer an overview of the literature on childhood onset schizophrenia. According to the authors, relatively little is known about childhood onset schizophrenia, which makes it difficult for clinicians to make accurate diagnoses and offer interventions. Complicating matters is the fact that early onset schizophrenia is usually concurrent with developmental disorders and neurocognitive impairments. In some cases, the symptoms may be mistaken for autism spectrum disorders. The authors point to research showing that there are genetic factors that are also involved, urging researchers to develop differential diagnostic criteria. After outlining the etiology and epidemiological data, the authors proceed to discuss clinical profiles, diagnostic criteria, and comorbidity with other conditions like autism. Future research should focus on how to provide the most effective evaluations for early detection and also offer strategic therapeutic interventions, therapies, outreach, and support for families.
As a review of literature, the Untu, Moisa, Burlea, et al. (2015) study is far from robust. It is not a systematic literature review, but only offers an overview of studies on the topic of childhood onset schizophrenia. The researchers also fail to indicate how their review of literature was conducted, and do not utilize any of the tools of meta-analysis such as reworking the raw data. In spite of these methodological weaknesses, the study does reveal gaps in the literature that future researchers might fill. The researchers also offer information that might be helpful to clinicians, which may help prevent misdiagnoses because of the unique features of childhood schizophrenia. Without internal or external validity, though, the Untu, Moisa, Burlea, et al. (2015) study cannot be used as a guide for clinical practice. It is not an experimental study and does not offer specific information for clinicians working with children who exhibit signs of schizophrenia.
References
Untu, I., Moisa, S.M., Burlea, S.L., et al. (2015). Very early and early onset schizophrenia spectrum disorders. Revista Romana de Pediatrie 64(1): 24-27.
There is usually a gap of one or two years between the appearance of vague symptoms and the patient's visit to a psychiatric clinic. Neurological examination may reveal a link between schizophrenia and Wilson's disease and Huntington's disease before treatment starts. The disorder has also been associated with left and mixed handedness, some physical abnormalities and mild neurological signs (Frankenburg). Mental status examination often reveals odd and poorly understood behaviors,
Schizophrenia Psychosis and Lifespan D Schizophrenia and Psychosis and Lifespan Development Schizophrenia and Psychosis Matrix Disorder Major DSM-IV-TR Categories Classifications Subclassifications Schizophrenia and Psychosis Symptoms Positive (Type I): represent excesses or distortions from normal functioning Delusions Bizarre Nonbizarre Hallucinations Auditory Visual Disorganized Speech Loose Association Neologisms Clang Associations Echolalia/Echopraxia Word Salad Grossly disorganized behavior Catatonic: motoric Waxy Flexibility Negative (Type II): the absence of functioning Apathy Affective Flattening Withdrawal Anhedonia Avolition Poor Concentration Poverty of speech Alogia Schizophrenia and Psychosis Diagnostic Types Paranoid Delusions and Hallucinations Disorganized Disorganized speech Disorganized behavior Withdrawal Affective flattening Catatonic Grossly disorganized behavior Disorganized speech Catatonic Echolalia/Echopraxia Undifferentiated Active symptoms that do not fit other diagnostic types Residual No Type I symptoms but some negative symptoms Schizoaffective
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