Social impairment may be specific to early-onset schizophrenia
medwireNews: Children and adolescents with schizophrenia have greater social impairment and developmental abnormalities than those with bipolar disorder, while both sets of patients have difficulties adapting to school, Spanish study findings suggest.
"Our results suggest that early-onset schizophrenia and psychotic bipolar disorder are two serious diseases that show impairments in different domains before the onset of illness," says the team.
While social impairment and developmental abnormalities appear to be more specific markers of early-onset schizophrenia, low intelligence and adaptive scholastic difficulties seem to be more non-specific and linked to general psychosis, they explain.
The team studied data from a 2-year longitudinal, multicenter Spanish study of 46 children and adolescents with schizophrenia, 23 with bipolar disorder, and 91 mentally healthy controls. Sociodemographic variables and the presence of developmental abnormalities were assessed, and premorbid adjustment was determined with the premorbid adjustment scale (PAS).
As reported in Schizophrenia Research, the children and adolescents with psychiatric conditions had worse scores on all childhood dimensions and items on the PAS, except for scholastic performance. Interestingly, those with schizophrenia had significantly worse scores on the sociability and withdrawal item than both controls and those with bipolar disorder.
Patients with schizophrenia also had a significantly higher prevalence of developmental abnormalities than controls and patients with bipolar disorder (27.3 vs 11.1 vs 4.3, respectively).
Both patients with bipolar disorder and schizophrenia had significantly lower mean premorbid intelligence quotient scores than healthy controls, at 87 and 86 versus 103, respectively. Mean parental years of education and parental socioeconomic status were significantly higher for controls than for both patient groups.
Schizophrenia and bipolar disorder patients both had worse total, social, and academic PAS scores in early adolescence than controls, but there were no significant differences between patient groups. The team also found that patients with schizophrenia or bipolar disorder had a greater worsening on adaptation to school item scores between childhood and early adolescence versus controls, at changes of 0.9, 0.94, and 0.09, respectively.
Beatriz Payá (Hospital Universitario Marques de Valdecilla, Santander) and colleagues write: "Our comparison revealed that [patients with schizophrenia] clearly differed in their global adjustment compared with the control group between the two periods that precede onset of illness. This finding suggests that worsening of global adjustment between childhood and early adolescence may be a marker of vulnerability or transition to illness."
They add: "Since teachers have a good understanding of the social and adaptive functioning of individuals, the school environment may be ideal for implementing some early identification strategies."
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By Liam Davenport, medwireNews Reporter