期刊名称：Journal of Indian Association for Child and Adolescent Mental Health
电子版ISSN：0973-1342
出版年度：2006
卷号：2
期号：1
页码：18-30
出版社：Indian Association for Child and Adolescent Mental Health
摘要：Background: Childhood onset schizophrenia (COS) is a rare disorder. Comparative data on the
effect of differential age of onset on clinical profile in schizophrenia are very few. Method:
Subjects with COS (n=15), adolescence onset schizophrenia (AdOS, n=20) and adulthood onset
schizophrenia (AOS, n=20) were compared on socio-demographic, clinical and genetic history
parameters using Instrument for the Retrospective Assessment of the Onset of Schizophrenia
(IRAOS), Positive and Negative Symptoms Scale (PANSS), Family Instrument for Genetic
Studies (FIGS), Wechsler’s Adult Intelligence Scale-Revised (WAIS-R), Malin’s Intelligence
Scale for Indian Children (MISIC) and WHO Life Chart Schedule (WHO LCS). Results:
Significantly higher rate of socioeconomic dependence, poorer academic performance, and nonparanoid
subtype was seen in the COS group as compared to the AdOS and AOS. The total
score on PANSS was maximum in the COS group with AdOS taking an intermediate position.
COS patients had more somatic and obsessive symptoms whereas, AdOS patients had more selfinjurious
behaviour and suicidal attempts. The response to typical antipsychotic medication was
poorer in the COS group as compared to the other two groups. In spite of treatment with atypical
antipsychotics (including clozapine), 1/3rd of the COS patients continued to show limited
response. The COS group scored least on the Mean IQ. The outcome was significantly poorer in
patients of COS (33%), and it correlated significantly with low IQ. Conclusions: COS seems to
be a more severe form of the schizophrenic illness with high degree of socioeconomic
dependence, poorer response to treatment, greater and more florid psychopathology, poorer
course and outcome, greater neurocognitive deficits and qualitative differences in the type of
schizophrenia and non-specific symptom profile as compared to the later onset schizophrenias.
