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Schizophrenia and related disorders in children and adolescents

  • H. Remschmidt
  • F. M. Theisen

Summary

This paper reviews the concept and recent studies on childhood and adolescent psychoses with special reference to schizophrenia. After a short historical introduction, the definition, classification, and epidemiology of child- and adolescent-onset psychoses are described, pointing out that some earlyonset psychotic states seem to be related to schizophrenia (such as infantile catatonia) and others not (such as desintegrative disorder).

The frequency of childhood schizophrenia is less than 1 in 10,000 children, but there is a remarkable increase in frequency between 13 and 18 years of age. Currently, schizophrenia is diagnosed according to ICD-10 and DSM-IV criteria. The differential diagnosis includes autism, desintegrative disorder, multiplex complex developmental disorder (MCDD) respectively multiple developmental impairment (MDI), affective psychoses, Asperger syndrome, druginduced psychosis and psychotic states caused by organic disorders.

With regard to etiology, there is strong evidence for the importance of genetic factors and for neurointegrative deficits preceding the onset of the disorder.

Treatment is based upon a multimodal approach including antipsychotic medication (mainly by atypical neuroleptics), psychotherapeutic measures, family-oriented measures, and specific measures of rehabilitation applied in about 30% of the patients after completion of inpatient treatment.

The long-term course of childhood- and adolescent-onset schizophrenia is worse than in adulthood schizophrenia, and the patients with manifestation of the disorder below the age of 14 have a very poor prognosis.

Keywords

Negative Symptom Psychotic Disorder Asperger Syndrome Acad Child Adolesc Psychiatry Atypical Neuroleptic 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag/Wien 2005

Authors and Affiliations

  • H. Remschmidt
    • 1
  • F. M. Theisen
    • 1
  1. 1.Department of Child and Adolescent PsychiatryPhilipps-UniversityMarburgGermany

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