Normal cerebral volume asymmetries in early onset schizophrenia.

BACKGROUND: Abnormalities in cerebral lateralization are thought to reflect early neurodevelopmental defects in schizophrenia. The aim of this study was to examine whether there is abnormal brain lateralization in early onset schizophrenia (EOS) and whether it is related to the unusually early onset of the disorder. METHODS: Adolescent patients with recent onset schizophrenia and an equal number of matched control subjects participated in the study. The volumes of the occipitoparietal, sensorimotor, premotor, prefrontal, and temporal regions were measured bilaterally from magnetic resonance images using stereological methods. Asymmetry indexes were calculated for each region using the formula ([R - L]/[R + L]) x 100. A composite index of asymmetry (torque) was computed as the sum of the five index scores. RESULTS: A total of 40 patients with EOS and 40 age-matched controls were enrolled. There were no group differences in demographic characteristics. No group differences in brain asymmetry measures were seen in any of the brain regions examined. CONCLUSIONS: The unusually early onset of schizophrenia in this population does not appear to be associated with abnormalities in hemispheric lateralization.

Increased developmental deviance and premorbid dysfunction in early onset schizophrenia.

Abnormal neurodevelopment and poor premorbid function have been described in schizophrenia. It is unclear whether abnormalities in these domains are increased in patients with early onset schizophrenia (EOS; onset before the 18th birthday) and whether they act to precipitate the earlier onset of the disorder. To address these questions, we collected information based on maternal interviews about the premorbid function of 40 adolescents with recent onset schizophrenia and an equal number of healthy controls using the Developmental Scale Score, the Premorbid Schizoid and Schizotypal Trait Scale (PSST) and Premorbid Adjustment Scale (PAS). Data on the PSST and PAS were also available in 54 patients with adult onset schizophrenia (AOS; onset after the 20th birthday). Compared to healthy controls, EOS patients had (a). delayed speech milestones, difficulties in reading and spelling and greater overall developmental deviance; (b). poor premorbid adjustment in childhood, which became even more deviant in adolescence particularly in boys and (c). more schizophrenia spectrum traits. Both premorbid adjustment and personality traits were more abnormal in patients with increased developmental deviance suggesting the possibility that they represent different manifestations of ongoing abnormalities in developmental processes. EOS patients had more impaired premorbid adjustment in adolescence and schizophrenia spectrum traits compared to AOS cases. Age of onset was related to developmental deviance, premorbid schizophrenia spectrum traits and childhood adjustment in EOS patients only.

Section 136 and African/Afro Caribbean minorities

Social, demographic and clinical information was collected retrospectively on all 99 people referred to a South London hospital in 1986 under Section 136 of the Mental Health Act (1983), this being the last complete year before local changes in the procedure for assessment of Section 136 cases were initiated. An over-representation of Afro-Caribbeans was confirmed and thia seemed to be accounted for largely by young men under the age of 30 who with Africans had very high rates of previous Section 136 referral, were more likely to be percieved as threatening, incoherent and disturbed but less clearly diagnosed with a mental illness, and were more likely than the Caucasian sample to be living in stable accommodation. The implications of these results are discussed. (Summary)