Are There Differences in Neurocognition and Social Cognition Among Adolescents with Schizophrenia, a Pervasive Developmental Disorder, and Both Disorders?

Schizophrenia (SCH) and pervasive developmental disorders (PDDs) belong to different diagnostic categories. There is, however, overlap between these 2 diagnostic groups. The aim of this preliminary study was to evaluate some aspects of neurocognitions and social cognitions in adolescents with SCH (n = 10, 2 boys and 8 girls; age range = 13.3-17.7 years), a PDD (n = 15, 7 boys and 8 girls; age range = 13.3-18.0 years), or both disorders (n = 8, 5 boys and 3 girls; age range = 13.5-18 years). Eight subtests (Information, Similarities, Arithmetic, Comprehension, Picture Completion, Coding B, Block Design, and Object Assembly) of the Wechsler Intelligence Scale for Children-Third Version and 2 subtests (Theory of Mind [ToM] and Affect Recognition) of the NEPSY-II were administered. Adolescents with both disorders and those with a PDD only performed better on visual processing tasks than did adolescents with SCH only. On the other hand, adolescents with both disorders as well as those with SCH only experienced more problems with processing speed than did adolescents with a PDD only. Adolescents with SCH only performed significantly more poorly with verbal ToM tasks compared with those with a PDD only. Adolescents with both disorders performed as well as those with SCH only. All in all, our preliminary findings support the current idea that SCH and PDDs are separate disorders.

Catatonic features in adolescents with schizophrenia with and without a comorbid pervasive developmental disorder.

BACKGROUND: Catatonia has been associated with both schizophrenia and pervasive developmental disorders. The aim of this study was to evaluate catatonic features among adolescents suffering from schizophrenia. Further, we compared these features between adolescents with a comorbid pervasive developmental disorder and those without one. Finally, we wanted to compare the profile of catatonia-like features of our schizophrenia patients to that described earlier among persons with autism spectrum disorders. METHODS: The study comprised a consecutive sample of 18 adolescents with schizophrenia (mean age 15.6 years, SD 1.4) and their families. Diagnosis of schizophrenia was assessed with the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Life-Time (K-SADS-PL) for the DSM-IV. The Diagnostic Interview for Social and Communication Disorders version 11 was used to assess catatonic features. RESULTS: All adolescents with schizophrenia had showed some lifetime catatonic features. Approximately 78% of them had already expressed these features before the age of 10. The number of catatonic features before the age of 10 was significantly higher among the adolescents with a comorbid pervasive developmental disorder compared to those without one. The numbers of catatonic features after the age of 10 did not significantly differ between the two groups. Over three-quarters of schizophrenia patients shared four lifetime catatonic features: "lacks facial expression", "odd intonation", "poor eye contact" and "lack of cooperation". CONCLUSIONS: Adolescent schizophrenia patients with a comorbid pervasive developmental disorder show many catatonic features in childhood whereas those without one seem to develop these features first in adolescence. Catatonic features exhibited by adolescents with schizophrenia resemble those described among persons with pervasive developmental disorders without schizophrenia.

The relationship between Asperger's syndrome and schizophrenia in adolescence.

Asperger's syndrome (AS), a pervasive developmental disorder (PDD), has nowadays been widely advocated in media. Therefore, psychiatrists treating adolescents frequently meet patients as well as their families reporting of symptoms resembling those of Asperger's syndrome. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. We describe a sample of 18 adolescents with early onset schizophrenia. Diagnosis of schizophrenia was based on assessment with Kiddie Schedule for Affective Disorders and Schizophrenia. The diagnostic interview for Social and Communication Disorders version 11 was used to assess autism spectrum disorders. Ten adolescents fulfilled symptom criteria of Asperger's syndrome after the onset of schizophrenia, while only two persons had Asperger's syndrome before the onset of schizophrenia, a prerequisite for diagnosis. 44% of the adolescents fulfilled the diagnosis of some PDD in childhood. Most of them were, however, unrecognized before the onset of schizophrenia. On the other hand, all 18 patients had one or more symptoms of PDDS in adolescence. Adolescents with schizophrenia have often symptoms consistent with AS, although only few of them have fulfilled the diagnostic criteria in their childhood, a prerequisite for the diagnosis of AS. There is a risk for misdiagnosis of adolescents with autistic symptoms if detailed longitudinal anamnesis is not obtained.

[Asperger's syndrome in females]. / Aspergerin oireyhtymä tytöillä ja naisilla.

Literature on Asperger's syndrome (AS) has mainly described symptoms that are manifested in boys. Only recently, attention has been paid on the features in AS girls that differ from the typical clinical picture and may complicate the detection of the syndrome. Because AS girls may react passively in general or compensate or hide their difficulties by other abilities, the need for support is not necessarily brought up. In that case this developmental disorder easily remains unrecognized. Recognition of the syndrome at an early stage makes early supportive actions possible.