Materiały źródłowe

• #1 Childhood-Onset Schizophrenia: The Challenge of Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3289250/

  During the past two decades, the Child Psychiatry Branch at the National Institute of Mental Health has conducted a longitudinal study (including long-term prospective follow-up) of childhood-onset schizophrenia, a rare form of the disorder. […] Childhood-onset schizophrenia (COS), characterized by onset before age 13 years, has a prevalence of approximately 1 in 40,000. This is a severe form of the illness with gradual onset and poor outcome. […] We ruled out 38% of all children screened as having alternative diagnoses with outpatient screening. […] Of the remaining 93 children admitted with provisional diagnoses of COS during the past decade, 30 (32%) were found during an inpatient observation that included a medication-free period to have an alternative diagnosis. […] Ruling out COS in severely ill, medicated children is particularly difficult for clinicians who see few COS children. An early and accurate diagnosis of COS will have profound implications for treatment. Conversely, ruling out a COS diagnosis has been equally important for future planning.

• #1 A Review of Childhood-Onset Schizophrenia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6526799/

  Pediatric schizophrenia consists of early-onset schizophrenia (onset prior to age 18 years) and childhood-onset schizophrenia (onset prior to age 13 years). […] The epidemiology, natural history, biopsychosocial underpinnings, assessment, differential diagnosis, and treatment of childhood-onset schizophrenia and early-onset schizophrenia are discussed in detail here. […] Early-onset schizophrenia refers to schizophrenia with symptom onset before the age of 18 years, whereas the rarer entity childhood-onset schizophrenia is defined as schizophrenia with symptom onset prior to age 13 years. […] Studies on the incidence of childhood-onset schizophrenia are lacking. One estimate by the National Institute of Mental Health (NIMH) is that the incidence is less than 0.04%. […] Childhood-onset schizophrenia frequently presents with a prodrome phase prior to the onset of florid psychotic symptoms.

• #1 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  Childhood-onset schizophrenia (COS) is rare in the United States; in preadolescents, the estimated prevalence is less than 1 case per 10,000 population. The number of new cases significantly increases during late adolescence, reaching an approximate prevalence of 1% for later-onset schizophrenia. Data from the British National Surveillance study suggests the 1-year incidence of COS of 0.21/100,000 and 1-year outcomes were poor. One study found that 11% of patients with First Episode Schizophrenia and 23% of patients at Clinical High Risk for psychosis reported remembering their first psychotic symptoms as presenting in childhood. […] One study in Denmark found the incidence of early-onset schizophrenia to increase when comparing the time period of 1971-1994 to 1994-2010. However, diagnostic criteria for early-onset schizophrenia changed during this time including letting go of a previous restriction that only allowed the diagnosis to be made in inpatient settings. While diagnostic incidence may have increased, it may have been accounted for by these changes in diagnostic criteria.

• #1 Childhood schizophrenia – Wikipedia

  https://en.wikipedia.org/wiki/Childhood_schizophrenia

  Schizophrenia disorders in children are rare. Boys are twice as likely to be diagnosed with childhood schizophrenia. There is often a disproportionately large number of males with childhood schizophrenia, because the age of onset of the disorder is earlier in males than females by about 5 years. […] While very early-onset schizophrenia is a rare event, with prevalence of about 1:40,000, early-onset schizophrenia manifests more often, with an estimated prevalence of 0.5%.

• #1 Schizophrenia in children and adolescents | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/schizophrenia-in-children-and-adolescents/2D4067DEC589778518559AE1F8C4DF38

  This article summarises new research, together with core features, course and outcome of schizophrenia with onset in childhood and adolescence, and investigates its neurobiology and continuity into adult life. […] Schizophrenia is one of the most devastating psychiatric disorders to affect children and adolescents. Although extremely rare before the age of 10, the incidence of schizophrenia rises steadily through adolescence to reach its peak in early adult life. The clinical severity, impact on development and poor prognosis of child- and adolescent-onset schizophrenia reinforce the need for early detection, prompt diagnosis and effective treatment. […] Reference Gillberg, Wahlstrom and ForsmanGillberg et al (1986) calculated age-specific prevalences for all psychoses (including schizophrenia, schizophreniform disorder, affective psychosis, atypical psychosis and drug psychoses) using Swedish case-register data on 13- to 18-year-olds with psychotic illnesses. In 41% of cases the diagnosis was schizophrenia. At 13 years of age, the prevalence for all psychoses in the general population was 0.9 per 10 000, showing a steady increase during adolescence, reaching a prevalence of 17.6 per 10 000 at age 18 years.

• #1

  https://link.springer.com/article/10.1007/s00787-021-01817-3

  There is a lack of information on changes in hospital admission rates for childhood-onset schizophrenia (COS), or on patient characteristics, to inform clinical research and health service provision. […] To report age- and sex-specific incidence rates of hospital admissions and day patient care for schizophrenia (ICD-10 F20) and non-affective psychosis (ICD-10 F20-29), by year of occurrence and age, in childhood and adolescence. […] The study confirms that childhood-onset schizophrenia is extremely rare, with only 32 cases identified over a 15-year period in the whole of England. […] Childhood-onset schizophrenia (COS), defined as onset before 13 years of age, is a serious, psychotic disorder with high rates of morbidity, mortality, and poor recovery. […] In England, schizophrenia accounts for a quarter of all psychiatric admissions in the age group 10-18 years, and the admission rate increases with age.

• #1 Schizophrenia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/288259-overview

  The lifetime prevalence of schizophrenia has generally been estimated to be approximately 1% worldwide. […] A systematic review by Saha et al of 188 studies drawn from 46 countries found a lifetime risk of 4.0 per 1000 population; prevalence estimates from countries considered least developed were significantly lower than those from countries classed as emerging or developed. […] Immigrants to developed countries show increased rates of schizophrenia, with the risk extending to the second generation. […] The onset of schizophrenia usually occurs between the late teens and the mid-30s. […] For males, the peak age of onset for the first psychotic episode is in the early to middle 20s; for females, it is in the late 20s. […] Although some variation by race or ethnicity has been reported, no racial differences in the prevalence of schizophrenia have been positively identified. […] The prevalence of schizophrenia is about the same in men and women. […] The onset of schizophrenia is later in women than in men, and the clinical manifestations are less severe.

• #1 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  Globally, schizophrenia with an onset later in life appears to have an equal prevalence, with a possible increase in prevalence in urban populations. Most studies demonstrate an average male-to-female incidence of schizophrenia of 1.52:1; this ratio is continually being re-examined and challenged. Males have a slight but statistically significant earlier age at onset, as well as higher rates of comorbid pervasive developmental disorder (PDD) and attention deficit/hyperactivity disorder (ADHS) when compared to females. The higher rates of comorbid PDD and ADHD with childhood-onset schizophrenia, however, mirror the same male-to-female ratios found in adult-onset schizophrenia. […] No studies of overall prevalence of childhood-onset schizophrenia in underdeveloped countries are available. A study of 409 pediatric patients with psychotic symptoms in Nigeria found 40.8% to have a diagnosis of schizophrenia, with 8.1% of the 409 patients being younger than 12 years old. Compared to pediatric patients with adolescent-onset psychotic symptoms, patients with childhood-onset psychotic symptoms were found to have less family history of psychiatric illness, more maternal illness during pregnancy, more illness in infancy, and overall more diagnoses of psychotic disorder due to another general medical condition as opposed to other diagnoses of psychosis.

• #1 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  The 2006 Aetiology and Ethnicity in Schizophrenia and Other Psychoses Study (AESOP), a large, population-based case-control study conducted over two years in three study centers in England in adults, reported all psychoses were more common in the black and minority ethnic group compared with the white British group. A British study of early-onset non-affective psychosis published in 2015 found no preference of gender, race, or ethnicity. […] One Finnish study also of early-onset schizophrenia found a statistical significance regarding birth interval. Patients with early-onset schizophrenia more often were born within 12 years of their nearest sibling. Interestingly, the effect of season of birth on diagnosis of schizophrenia has been the focus of multiple studies. A 2017 study of data from Korean patients was consistent with studies of other nationalities finding a predominance of winter births (particularly January and February) for patients diagnosed with early-onset schizophrenia.

• #1 Schizophrenia in Children | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/schizophrenia-children

  Schizophrenia is uncommon in children under the age of 12 and hard to identify in the early phases. […] Statistics indicate that schizophrenia affects approximately 1% of Americans. […] A child born into a family with 1 or more family members affected by schizophrenia has a greater chance of developing schizophrenia than a child born into a family with no history of schizophrenia. […] After a person has been diagnosed with schizophrenia in a family, the chance for a sibling to also be diagnosed with schizophrenia is 10%. […] If a parent has schizophrenia, the chance for a child to have the disorder is 10%. […] Risks increase with multiple affected family members.

• #1 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  Children at high risk for schizophrenia are those with a biological parent diagnosed with the disorder, significantly increasing their likelihood of developing schizophrenia themselves. Research indicates that these children face a 10-15% risk if one parent is affected, and the risk escalates to about 40% when both parents are diagnosed. […] Understanding the precursors to schizophrenia is crucial, as the disorder typically manifests in late adolescence or early adulthood, suggesting early intervention could be beneficial. […] Studies have shown that high-risk children may exhibit distinct developmental differences, including delays in motor skills, cognitive impairments, and social adjustment issues. […] Attention deficits, in particular, have emerged as a potential marker for genetic risk.

• #1 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  A 2020 meta-analysis of research concerning the genetic component of schizophrenia found that individuals with a close relative with schizophrenia are seven to eight times more likely to develop the condition, and those with more than one close relative with schizophrenia were up to eleven times more likely to develop the condition.

• #1 Frontiers | Childhood-Onset Schizophrenia: A Systematic Overview of Its Genetic Heterogeneity From Classical Studies to the Genomic Era

  https://www.frontiersin.org/journals/genetics/articles/10.3389/fgene.2019.01137/full

  Childhood-onset schizophrenia (COS), a very rare and severe chronic psychiatric condition, is defined by an onset of positive symptoms (delusions, hallucinations and disorganized speech or behavior) before the age of 13. […] Macro-lesional cytogenetic abnormalities such as copy number variations (CNVs), including the 22q11.21 deletion, are more frequent in COS than in AOS [10.6% of patients with COS (DSM-III-R, onset <13 years) vs. 2–5%, in AOS, p < 0.0001]. [...] Recently, Next Generation Sequencing (NGS) or “high throughput sequencing” allowed, with unprecedented scalability and speed, to determine the DNA sequence of a given individual. [...] The genetic overlap with ASD is also well documented and we show that 91% of described CNVs are also described in ASD (SFARI). [...] COS is characterized by a complex genetic architecture with both inherited and de novo mutations distributed in almost all chromosomes.

• #1 The Realities of Childhood Schizophrenia

  https://www.psychiatrictimes.com/view/realities-childhood-schizophrenia

  Although the diagnostic criteria used in children are the same as those for adults, there are some key differences in clinical presentation. […] Two large systematic studies demonstrate that 30% to 50% of patients with childhood onset schizophrenia had premorbid features of autism or had comorbid diagnoses of pervasive developmental disorders. […] A meta-analysis reported strong evidence that childhood adversity was associated with an increased risk for psychosis in adults, although psychotic symptoms may also be present in PTSD. […] Twin studies suggest that childhood-onset of schizophrenia may have a substantial genetic component. […] In terms of long-acting injectable antipsychotics, they have not been sufficiently studied in younger children to recommend their use. […] Prompt diagnosis of schizophrenia and aggressive treatment is necessary to limit impairments in development and learning.

• #1 Epidemiology of schizophrenia – Wikipedia

  https://en.wikipedia.org/wiki/Epidemiology_of_schizophrenia

  Schizophrenia affects around 0.30.7% of the general population at some point in life (i.e. lifetime prevalence), or 21 million people worldwide as of 2020 (about one of every 285). […] Early Onset schizophrenia in childhood, before the age of 13 can sometimes occur. […] In two natural experiments conducted on populations that experienced famine, the rates of schizophrenia diagnosed were observed. During both the Chinese Famine (1950s) and the Dutch Hunger Winter (19441945) the cohorts of the exposed group were twice as likely to develop schizophrenia as compared to the unexposed cohorts. […] It is possible that prenatal nutritional deficiency plays a role in the development of schizophrenia, in particular the lack of micronutrients. Countries with poor prenatal care, low food supply, or developing countries could have a higher incidence of schizophrenia, but more research is needed to confirm this hypothesis.

• #1 Schizophrenia in children and adolescents | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/schizophrenia-in-children-and-adolescents/2D4067DEC589778518559AE1F8C4DF38

  Males are over-represented in many clinical studies of childhood-onset schizophrenia (Reference Russell, Bott and SammonsRussell 1989; Reference Spencer and CampbellSpencer 1994). However, other studies of predominantly adolescent-onset schizophrenia have described an equal gender ratio (Reference HollisHollis 2000). […] The validity of the diagnosis of schizophrenia in childhood and adolescence is supported by follow-up studies into adulthood that show a high level of diagnostic stability (Reference HollisHollis 2000). […] The overall high rate of various cytogenetic abnormalities (seen in 10% of the NIMH sample) suggests the possibility of more subtle genomic instability similar to that seen in autism (Reference Rapoport, Addington and FrangouRapoport 2005). […] Cannabis confers an overall twofold increased risk of later schizophrenia (Reference Arseneault, Cannon and WittonArseneault 2004).

• #1 Who Gets Schizophrenia? By Age, Sex, and More

  https://www.webmd.com/schizophrenia/who-gets-schizophrenia-by-age-sex-more

  A third theory suggests that immigrants may have a higher risk for schizophrenia partly due to being low on vitamin D, especially among people who move to latitudes farther north. […] Some research ties living in a city or town to a higher risk for schizophrenia. Researchers arent sure what things in an urban environment might raise someones odds of getting the disorder.

• #1 Childhood-Onset Schizophrenia: The Challenge of Diagnosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3289250/

  Our experience demonstrates that a medication washout is very informative; we recognize that it is increasingly difficult to accomplish this in clinical practice. When possible, however, putative, early-onset psychosis patients should be observed medication free, and one must be particularly circumspect about the diagnosis of COS in children with depression and/or sporadic hallucinations.

• #1 Early-Onset Schizophrenia in a paediatric population of French psychiatric and medico-social care centres: A cross sectional study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236241

  The difficulty in diagnosing EOS is also related to its overlap with developmental and other child psychiatric disorders. […] The most frequent diagnosis was Pervasive Development Disorders (PDD). […] The average IQ of the total sample lies in the mild intellectual disability range, which is not surprising as 35.8% of children in this sample are from IME, institutions for children with intellectual disability. […] The majority of the children received reeducation and a large part followed individual psychotherapy. […] Our study demonstrates that the assessment of EOS diagnosis by standardized diagnostic tools involving the child, parents as well as the support team, is feasible in the pediatric population with neurodevelopmental disorders and intellectual deficiency.

• #1 Early-Onset Schizophrenia in a paediatric population of French psychiatric and medico-social care centres: A cross sectional study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236241

  Early-Onset Schizophrenia (EOS) is rare but severe mental health disorder in children and adolescents. […] In France, there are no recent reliable epidemiological data about the prevalence of EOS. […] The results of the study highlight the importance of using a standardized diagnostic tool for the diagnosis of schizophrenia in the paediatric population. […] Indeed, EOS might be underdiagnosed in children and adolescents with neurodevelopmental disorders and subnormal cognitive functioning. […] The rate of 8.9% (CI 95%: [6.2%; 12.7%]) EOS diagnosis in this sample of children and adolescents aged 7-18 years is higher compared to 12% in children and 5% in adolescents of the psychiatric populations described by Remschmidt and Theisen. […] The proportion of EOS diagnosis after assessment with Kiddie-SADS-PL was significantly higher than in the children’s medical record (8.9% vs 2.3%).

• #1

  https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Schizophrenia-In-Children-049.aspx

  Schizophrenia is a serious psychiatric illness that causes changes in thinking, feelings, and unusual or strange behavior. It is uncommon in children and hard to recognize in its early phases. Symptoms that are more prominent may be noted in adolescents and young adults. […] Early diagnosis and medical treatment are important. Schizophrenia is a life-long disease that can be controlled but not cured. […] The symptoms and behavior of children and adolescents with schizophrenia may be different from those of adults with this illness. […] Children with these symptoms must have a complete evaluation. Parents should ask their family physician or pediatrician to refer them to a child and adolescent psychiatrist, who is specifically trained and skilled at evaluating, diagnosing, and treating children with schizophrenia.

• #1 A Review of Childhood-Onset Schizophrenia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6526799/

  Insidious onset of symptoms, onset at a young age, lower intellectual functioning, lower premorbid functioning, and higher rates of negative symptoms are poor prognostic indicators. […] Monitoring for safety is equally important, with studies indicating that about 5% of patients with childhood-onset schizophrenia lose their life to suicide or as a direct result of dangerous behaviors when psychotic. […] The lifetime prevalence of schizophrenia is 1%, and the incidence of childhood schizophrenia is rare. […] Completing an accurate history and physical during the patient assessment, including a detailed neurological examination, are paramount. […] The antipsychotics continue to be significantly more effective than placebo in treating childhood-onset schizophrenia and early-onset schizophrenia. […] Given the rarity of this disorder, further study is still needed to better understand causality, improve assessment, and develop a definitive treatment algorithm.

• #1

  https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Schizophrenia-In-Children-049.aspx

  Treating children with schizophrenia can involve a combination of medication, individual therapy, and family therapy, and specialized programs (school, activities, etc.) are often necessary. Psychiatric medication can be helpful for many of the symptoms of the illness. These medications require careful monitoring by a psychiatrist (preferably a child and adolescent psychiatrist).

• #1 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  In a child younger than 13 years, the onset of schizophrenia is rare and is generally insidious, carrying a worse prognosis. Onset of the disorder in the adolescent years is more common and may have an acute or insidious onset. In general, the earlier the onset of schizophrenia, the poorer the outcome.

• #1 A systematic review of the long-term outcome of early onset schizophrenia | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-150

  The current review analyzes the long-term outcome and prognosis of early onset schizophrenia based on previously published studies in 1980. […] The prevalence of schizophrenia in children and adolescents is rather low, with estimates of VEOS varying between 1 in 10.000, 1 in 30.000 in children before age 13, and 1.4 in 10.000 before age 15. […] The current systematic review is focused on the analysis of the entire existing literature on the long-term outcome of EOS published since 1980 in English-language journals. […] The main findings are the following: (a) the outcome for EOS is relatively poor and less favourable than in MIX samples; (b) samples with high dropout rates report less moderate and more poor outcomes, even though the effect sizes are small; (c) the effect sizes of measures of functioning are also small, which can be attributed to the fact that in EOS samples global measures of functioning are associated with less good and poor outcomes than specific measures of functioning; however, in the MIX samples, specific measures of functioning are associated with better outcomes on all three levels; (d) in EOS, the effect of duration of follow-up shows less favourable outcomes after more than 10 years of follow-up, whereas in MIX samples, the longer follow-up is associated with more good, less moderate, and more poor outcomes; (e) the outcome in both EOS and MIX samples is less favourable in males; and (f) the outcome is better in patients who had been diagnosed in more recent decades.

• #1 Schizophrenia in children and adolescents | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/schizophrenia-in-children-and-adolescents/2D4067DEC589778518559AE1F8C4DF38

  The brain changes reported in childhood-onset schizophrenia appear to be very similar to those described in adult schizophrenia, supporting the idea of an underlying neurobiological continuity. […] Adolescent schizophrenia is associated with poor premorbid functioning and early developmental delays (Reference Alaghband-Rad, McKenna and GordonAlaghband-Rad 1995; Reference HollisHollis 1995 Reference Hollis2003). […] The predictors of poor outcome in adolescent-onset schizophrenia include premorbid social and cognitive impairments, a prolonged first psychotic episode, extended duration of untreated psychosis and the presence of negative symptoms (Reference Hollis, Rutter, Bishop and PineHollis 2008). […] The past decade has seen a dramatic growth in our understanding of the clinical course and neurobiological underpinnings of adolescent schizophrenia. It is now clear that adult-based diagnostic criteria have validity in this age group and the disorder has clinical and neurobiological continuity with schizophrenia in adults.

• #1

  https://link.springer.com/article/10.1007/BF02190734

  A total of 232 (84%) first episodes of schizophrenia from our epidemiologically defined ABC sample (Age, Beginning and Course) were retrospectively assessed with regard to the onset and early course of the disorder. […] Population-based incidence rates for 5-year age groups comprising a range of 10-60 years were calculated on the basis of two definitions of onset: first sign of disorder and first psychotic symptom. […] Early-onset schizophrenias (-20 years) were compared with a medium-onset group (21-35 years) and a late-onset group (35-60 years) with regard to age and type of onset, early symptom-related course, social development and social course. […] An earlier onset of schizophrenia has more severe social consequences than onset in adults, because it interrupts the cognitive and social development at an earlier stage.

• #1

  https://link.springer.com/article/10.1007/BF02190734

  The worse social course of schizophrenia in men compared with women cannot be related to a more severe symptomatology, but to the earlier age at onset and the impairment or stagnation of social ascent at an earlier stage of social and cognitive development. […] Social disability in the sense of an adaptation to the expectations of the social environment, as well as symptomatology during the further course of schizophrenia, show no major differences between the genders nor between the age groups.

• #1 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  Ongoing research aims to track these children from childhood into adulthood to identify specific signs of vulnerability, which may ultimately inform preventive strategies. […] The complexities surrounding early intervention, including ethical considerations and the potential side effects of treatment, highlight the importance of careful monitoring and individualized care for these at-risk populations. […] Research concerning children of parents with schizophrenia aims to identify the indicators of risk for psychiatric conditions. Longitudinal studies may provide information regarding developmental precursors of adult schizophrenia. Early intervention programs involve the administration of preventive medication to targeted at-risk individuals. […] Between 0.30 and 0.45 percent of the global population is diagnosed with schizophrenia. In contrast, children who have one biological parent with schizophrenia have a 13 percent chance of developing the disorder. When both biological parents are diagnosed with schizophrenia, the risk rate is around 40 percent.

• #1 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  Researchers have studied these individuals and their children to understand the origins of schizophrenia. […] Conducting longitudinal studies of children with a genetic predisposition to psychiatric conditions is an efficient way of studying individuals who are most likely to develop schizophrenia. […] The results from studies of high-risk children suggest that the predisposition for schizophrenia may be detectable at an early age. […] These findings confirm the predictions made by the researchers. Specifically, the high-risk children who eventually develop schizophrenia show more evidence of motor abnormalities, memory deficits, and attention dysfunction in childhood than their peers. […] The findings of neurobehavioral abnormalities in preschizophrenic individuals during childhood are consistent with the etiologic hypotheses held by most researchers in the field.

• #1 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  These research findings indicate that individuals who develop schizophrenia in adulthood manifest signs of vulnerability long before the onset of the disorder, perhaps as early as infancy. […] Since the late 1990s, several clinicians and investigators in North America, Europe, and Australia have begun to identify and treat adolescents and young adults at clinical risk for schizophrenia or in the prodromal phase of the disorder. […] The goal of high-risk research is to identify factors that can successfully predict those who are most likely to develop subsequent cases of schizophrenia or schizophrenia-related disorders. […] The interim findings of early intervention studies have become available. Overall, the studies are consistent in terms of the percentage of at-risk individuals who developed a psychotic disorder within approximately two years.

• #2 A Review of Childhood-Onset Schizophrenia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6526799/

  Pediatric schizophrenia consists of early-onset schizophrenia (onset prior to age 18 years) and childhood-onset schizophrenia (onset prior to age 13 years). […] The epidemiology, natural history, biopsychosocial underpinnings, assessment, differential diagnosis, and treatment of childhood-onset schizophrenia and early-onset schizophrenia are discussed in detail here. […] Early-onset schizophrenia refers to schizophrenia with symptom onset before the age of 18 years, whereas the rarer entity childhood-onset schizophrenia is defined as schizophrenia with symptom onset prior to age 13 years. […] Studies on the incidence of childhood-onset schizophrenia are lacking. One estimate by the National Institute of Mental Health (NIMH) is that the incidence is less than 0.04%. […] Childhood-onset schizophrenia frequently presents with a prodrome phase prior to the onset of florid psychotic symptoms.

• #2 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  Childhood-onset schizophrenia (COS) is rare in the United States; in preadolescents, the estimated prevalence is less than 1 case per 10,000 population. The number of new cases significantly increases during late adolescence, reaching an approximate prevalence of 1% for later-onset schizophrenia. Data from the British National Surveillance study suggests the 1-year incidence of COS of 0.21/100,000 and 1-year outcomes were poor. One study found that 11% of patients with First Episode Schizophrenia and 23% of patients at Clinical High Risk for psychosis reported remembering their first psychotic symptoms as presenting in childhood. […] One study in Denmark found the incidence of early-onset schizophrenia to increase when comparing the time period of 1971-1994 to 1994-2010. However, diagnostic criteria for early-onset schizophrenia changed during this time including letting go of a previous restriction that only allowed the diagnosis to be made in inpatient settings. While diagnostic incidence may have increased, it may have been accounted for by these changes in diagnostic criteria.

• #2 A systematic review of the long-term outcome of early onset schizophrenia | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-150

  The current review analyzes the long-term outcome and prognosis of early onset schizophrenia based on previously published studies in 1980. […] The prevalence of schizophrenia in children and adolescents is rather low, with estimates of VEOS varying between 1 in 10.000, 1 in 30.000 in children before age 13, and 1.4 in 10.000 before age 15. […] The current systematic review is focused on the analysis of the entire existing literature on the long-term outcome of EOS published since 1980 in English-language journals. […] The main findings are the following: (a) the outcome for EOS is relatively poor and less favourable than in MIX samples; (b) samples with high dropout rates report less moderate and more poor outcomes, even though the effect sizes are small; (c) the effect sizes of measures of functioning are also small, which can be attributed to the fact that in EOS samples global measures of functioning are associated with less good and poor outcomes than specific measures of functioning; however, in the MIX samples, specific measures of functioning are associated with better outcomes on all three levels; (d) in EOS, the effect of duration of follow-up shows less favourable outcomes after more than 10 years of follow-up, whereas in MIX samples, the longer follow-up is associated with more good, less moderate, and more poor outcomes; (e) the outcome in both EOS and MIX samples is less favourable in males; and (f) the outcome is better in patients who had been diagnosed in more recent decades.

• #2 The Realities of Childhood Schizophrenia

  https://www.psychiatrictimes.com/view/realities-childhood-schizophrenia

  Although the diagnostic criteria used in children are the same as adults, there are some key differences in clinical presentation of psychotic features. […] The worldwide prevalence of early onset schizophrenia, that is symptoms prior to the age of 18yrs is estimated to be about 0.5% of the population, whereas childhood onset or very early onset schizophrenia which begins prior to the age of 13, has been estimated to be around 0.04% in the United States. Much less is known about the prevalence of childhood onset schizophrenia internationally. […] Although there is no official age considered too young for a diagnosis of schizophrenia, we have to keep in mind that childhood-onset schizophrenia that starts before aged 13 years is extremely rare. […] In terms of diagnosis, DSM-5 diagnostic criteria for schizophrenia in childhood and adolescence are the same as those used for adult disorders.

• #2

  https://link.springer.com/article/10.1007/s00787-021-01817-3

  The analyses in the national study included all children aged 5-17 years who had a hospital record with a diagnosis of schizophrenia and non-affective psychosis. […] The number of cases of COS varied from year to year, with no cases in some years. […] Childhood-onset schizophrenia is very rare indeed. There were only 32 hospitalised cases of COS in the whole of England (population 55 million) over a period of 15 years, with a hospitalised incidence rate in 2016 in males of 0.03 per 100,000 population and in females of 0.01 per 100,000 population. […] Our results confirm the very low rates of admission for COS with an increase in schizophrenia admissions during adolescence. […] An overall higher rate of schizophrenia in males has been observed, although there are fewer gender differences reported in COS. […] In conclusion, this is the largest epidemiological study of schizophrenia diagnosed before the age of 13 years.

• #2 Childhood-Onset Schizophrenia: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/914840-overview

  Globally, schizophrenia with an onset later in life appears to have an equal prevalence, with a possible increase in prevalence in urban populations. Most studies demonstrate an average male-to-female incidence of schizophrenia of 1.52:1; this ratio is continually being re-examined and challenged. Males have a slight but statistically significant earlier age at onset, as well as higher rates of comorbid pervasive developmental disorder (PDD) and attention deficit/hyperactivity disorder (ADHS) when compared to females. The higher rates of comorbid PDD and ADHD with childhood-onset schizophrenia, however, mirror the same male-to-female ratios found in adult-onset schizophrenia. […] No studies of overall prevalence of childhood-onset schizophrenia in underdeveloped countries are available. A study of 409 pediatric patients with psychotic symptoms in Nigeria found 40.8% to have a diagnosis of schizophrenia, with 8.1% of the 409 patients being younger than 12 years old. Compared to pediatric patients with adolescent-onset psychotic symptoms, patients with childhood-onset psychotic symptoms were found to have less family history of psychiatric illness, more maternal illness during pregnancy, more illness in infancy, and overall more diagnoses of psychotic disorder due to another general medical condition as opposed to other diagnoses of psychosis.

• #2 Schizophrenia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/288259-overview

  The lifetime prevalence of schizophrenia has generally been estimated to be approximately 1% worldwide. […] A systematic review by Saha et al of 188 studies drawn from 46 countries found a lifetime risk of 4.0 per 1000 population; prevalence estimates from countries considered least developed were significantly lower than those from countries classed as emerging or developed. […] Immigrants to developed countries show increased rates of schizophrenia, with the risk extending to the second generation. […] The onset of schizophrenia usually occurs between the late teens and the mid-30s. […] For males, the peak age of onset for the first psychotic episode is in the early to middle 20s; for females, it is in the late 20s. […] Although some variation by race or ethnicity has been reported, no racial differences in the prevalence of schizophrenia have been positively identified. […] The prevalence of schizophrenia is about the same in men and women. […] The onset of schizophrenia is later in women than in men, and the clinical manifestations are less severe.

• #2 The Realities of Childhood Schizophrenia

  https://www.psychiatrictimes.com/view/realities-childhood-schizophrenia

  Although the diagnostic criteria used in children are the same as those for adults, there are some key differences in clinical presentation. […] Two large systematic studies demonstrate that 30% to 50% of patients with childhood onset schizophrenia had premorbid features of autism or had comorbid diagnoses of pervasive developmental disorders. […] A meta-analysis reported strong evidence that childhood adversity was associated with an increased risk for psychosis in adults, although psychotic symptoms may also be present in PTSD. […] Twin studies suggest that childhood-onset of schizophrenia may have a substantial genetic component. […] In terms of long-acting injectable antipsychotics, they have not been sufficiently studied in younger children to recommend their use. […] Prompt diagnosis of schizophrenia and aggressive treatment is necessary to limit impairments in development and learning.

• #2

  https://austinpublishinggroup.com/schizophrenia/fulltext/schizophrenia-v3-id1026.php

  The onset of schizophrenia is later in women than in men, and the clinical manifestations are less severe. […] Children born in the winter months may be at greater risk for developing schizophrenia. […] Winter birth in people who later develop schizophrenia is a robust epidemiological finding, at least in the northern hemisphere.

• #2 Childhood schizophrenia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483

  Childhood schizophrenia is an uncommon but severe mental disorder in which children and teenagers interpret reality abnormally. […] Childhood schizophrenia is essentially the same as schizophrenia in adults, but it starts early in life generally in the teenage years and has a profound impact on a child’s behavior and development. […] Schizophrenia is considered early onset when it starts before the age of 18. Onset of schizophrenia in children younger than age 13 is extremely rare. […] It’s not known what causes childhood schizophrenia, but it’s thought that it develops in the same way as adult schizophrenia does. Researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder. […] Although the precise cause of schizophrenia isn’t known, certain factors seem to increase the risk of developing or triggering schizophrenia, including having a family history of schizophrenia. […] Left untreated, childhood schizophrenia can result in severe emotional, behavioral and health problems. […] Early identification and treatment may help get symptoms of childhood schizophrenia under control before serious complications develop.

• #2 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  Ongoing research aims to track these children from childhood into adulthood to identify specific signs of vulnerability, which may ultimately inform preventive strategies. […] The complexities surrounding early intervention, including ethical considerations and the potential side effects of treatment, highlight the importance of careful monitoring and individualized care for these at-risk populations. […] Research concerning children of parents with schizophrenia aims to identify the indicators of risk for psychiatric conditions. Longitudinal studies may provide information regarding developmental precursors of adult schizophrenia. Early intervention programs involve the administration of preventive medication to targeted at-risk individuals. […] Between 0.30 and 0.45 percent of the global population is diagnosed with schizophrenia. In contrast, children who have one biological parent with schizophrenia have a 13 percent chance of developing the disorder. When both biological parents are diagnosed with schizophrenia, the risk rate is around 40 percent.

• #2 Linking childhood trauma to the psychopathology of schizophrenia: the role of oxytocin | Schizophrenia

  https://www.nature.com/articles/s41537-024-00433-9

  Childhood trauma is recognized as a factor indicating vulnerability to psychotic symptoms and schizophrenia. Evidence indicates that patients with schizophrenia are more likely to report a history of childhood adversity or trauma than healthy controls are. Research has consistently identified increased risks of developing psychotic disorders and schizophrenia in the context of various factors among individuals with the experience of child adversity or trauma, though establishing direct causality remains complex. Patients with schizophrenia who experienced childhood trauma are typically younger age at schizophrenia onset, have worse psychotic symptoms, have more severe functional impairment, respond to treatment more poorly, and have an even higher risk of suicide than those who did not experience childhood trauma.

• #2 Who Gets Schizophrenia? By Age, Sex, and More

  https://www.webmd.com/schizophrenia/who-gets-schizophrenia-by-age-sex-more

  An estimated 1% of people around the world live with schizophrenia, a mental illness that affects how you think, feel, and act. The number of new cases per year is about 1.5 per 10,000 people. Heres more on the epidemiology of schizophrenia. […] Symptoms tend to start in your late teens, 20s, or early to mid 30s. Men may be more likely to get their first symptoms or their first bout of psychosis earlier than women do. […] Its rare for someone to start showing symptoms as a child or when theyre over 45 years old. […] Many studies in several countries have observed that the disorder happens more often among people whove immigrated, compared to native-born people. The higher risk seems to apply to second-generation immigrants, too. […] Some research suggests that groups of immigrants who face more discrimination may have higher rates of schizophrenia than those who face less discrimination.

• #2 Early-Onset Schizophrenia in a paediatric population of French psychiatric and medico-social care centres: A cross sectional study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236241

  The difficulty in diagnosing EOS is also related to its overlap with developmental and other child psychiatric disorders. […] The most frequent diagnosis was Pervasive Development Disorders (PDD). […] The average IQ of the total sample lies in the mild intellectual disability range, which is not surprising as 35.8% of children in this sample are from IME, institutions for children with intellectual disability. […] The majority of the children received reeducation and a large part followed individual psychotherapy. […] Our study demonstrates that the assessment of EOS diagnosis by standardized diagnostic tools involving the child, parents as well as the support team, is feasible in the pediatric population with neurodevelopmental disorders and intellectual deficiency.

• #2 Schizophrenia in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/s/schizophrenia-in-children.html

  Schizophrenia is not often found in children younger than age 12. It’s also hard to spot in the early stages. Often, the psychotic symptoms start in the middle to late teen years. Slightly more boys develop it in childhood. But by the teen years, it affects both sexes equally. […] Schizophrenia tends to run in families. A child who has a family member with the disorder has a greater chance of developing it. […] A child with symptoms of schizophrenia needs a thorough medical and mental health evaluation. […] A mental health expert can diagnose schizophrenia. Ask for a referral to a psychiatrist with experience evaluating and treating children with schizophrenia. […] Schizophrenia may increase a child’s risk for suicidal thinking. […] Schizophrenia is a serious, lifelong mental illness. It can be treated but not cured. […] Symptoms can develop slowly over time or start quickly. […] Treatment can include a combination of medicine, therapy, and special programs.

• #2 Schizophrenia in children and adolescents: Epidemiology, clinical features, assessment, and diagnosis – UpToDate

  https://www.uptodate.com/contents/schizophrenia-in-children-and-adolescents-epidemiology-clinical-features-assessment-and-diagnosis/print

  Schizophrenia in children and adolescents is a syndrome consisting of positive and negative symptoms of psychosis that impact development and cognitive functioning. The etiology of this syndrome is poorly understood; early diagnosis and treatment are critical to limit the morbidity of the disorder. […] Childhood-onset schizophrenia usually represents a more severe form of the disorder, with more prominent prepsychotic developmental disorders, structural brain abnormalities, and genetic risk factors. […] This topic reviews the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of schizophrenia in children and adolescents.

• #2 A systematic review of the long-term outcome of early onset schizophrenia | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-150

  The outcome of schizophrenia is worse than for other psychotic disorders, which applies to both adult and early onset schizophrenia. […] This exhaustive analysis of the available evidence on the outcome of EOS and VEOS points to the still rather poor prognosis of early manifestations of schizophrenia.

• #2 Schizophrenia in children and adolescents | BJPsych Advances | Cambridge Core

  https://www.cambridge.org/core/journals/bjpsych-advances/article/schizophrenia-in-children-and-adolescents/2D4067DEC589778518559AE1F8C4DF38

  The brain changes reported in childhood-onset schizophrenia appear to be very similar to those described in adult schizophrenia, supporting the idea of an underlying neurobiological continuity. […] Adolescent schizophrenia is associated with poor premorbid functioning and early developmental delays (Reference Alaghband-Rad, McKenna and GordonAlaghband-Rad 1995; Reference HollisHollis 1995 Reference Hollis2003). […] The predictors of poor outcome in adolescent-onset schizophrenia include premorbid social and cognitive impairments, a prolonged first psychotic episode, extended duration of untreated psychosis and the presence of negative symptoms (Reference Hollis, Rutter, Bishop and PineHollis 2008). […] The past decade has seen a dramatic growth in our understanding of the clinical course and neurobiological underpinnings of adolescent schizophrenia. It is now clear that adult-based diagnostic criteria have validity in this age group and the disorder has clinical and neurobiological continuity with schizophrenia in adults.

• #2

  https://link.springer.com/article/10.1007/BF02190734

  The worse social course of schizophrenia in men compared with women cannot be related to a more severe symptomatology, but to the earlier age at onset and the impairment or stagnation of social ascent at an earlier stage of social and cognitive development. […] Social disability in the sense of an adaptation to the expectations of the social environment, as well as symptomatology during the further course of schizophrenia, show no major differences between the genders nor between the age groups.

• #2 Children at high risk for schizophrenia | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/children-high-risk-schizophrenia

  These research findings indicate that individuals who develop schizophrenia in adulthood manifest signs of vulnerability long before the onset of the disorder, perhaps as early as infancy. […] Since the late 1990s, several clinicians and investigators in North America, Europe, and Australia have begun to identify and treat adolescents and young adults at clinical risk for schizophrenia or in the prodromal phase of the disorder. […] The goal of high-risk research is to identify factors that can successfully predict those who are most likely to develop subsequent cases of schizophrenia or schizophrenia-related disorders. […] The interim findings of early intervention studies have become available. Overall, the studies are consistent in terms of the percentage of at-risk individuals who developed a psychotic disorder within approximately two years.

• #3 Childhood schizophrenia – Wikipedia

  https://en.wikipedia.org/wiki/Childhood_schizophrenia

  Schizophrenia disorders in children are rare. Boys are twice as likely to be diagnosed with childhood schizophrenia. There is often a disproportionately large number of males with childhood schizophrenia, because the age of onset of the disorder is earlier in males than females by about 5 years. […] While very early-onset schizophrenia is a rare event, with prevalence of about 1:40,000, early-onset schizophrenia manifests more often, with an estimated prevalence of 0.5%.

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