Assessment of the initial period of schizotypal disorder in childhood

Abstract

To identify developmental features, the presence of hereditary burden, social adaptation, the structure of early psychopathological disorders in pediatric patients with schizotypal disorder (STD) and their relationship with the age of manifestation and the clinical structure of the disease. The study included 150 patients aged 7 to 16 years with a diagnosis of SD, of which 48 were female and 102 were male. Based on the age of onset of the first stable psychopathological disorders, at the stage preceding the diagnosis of SD, 5 groups of patients were identified: up to 3 years (n=38), from 4 to 6 years (n=36), from 7 to 10 years (n=15), 11-13 (n=41), 14-16 years old (n=20). The study used clinical-psychopathological, clinical-catamnestic, with a retrospective analysis, neurological, pathopsychological, psychometric and statistical research methods. A high frequency of deviations from normative parameters in early psychomotor development was found in 99 (65%) patients with STD. Mental retardation was observed in 23 (15%) patients, dissociation in mental development was detected in a significant number of patients - 62 (41%). At the same time, the most significantly more frequent and pronounced were violations in the two youngest groups with the onset of psychopathological disorders up to 6 years. In these groups, there was also more often a deficit in three areas at once - emotional, motivational and volitional (38%) compared with the 4th group (13%). In groups 1 and 2, a deficit in intellectual development was also characteristic, which was reflected in academic indicators. High performance in the primary grades was observed in 16% of patients in the 1st group versus 60% in the 5th, and poor performance was found in 37% in the 1st group and only 5% in the 5th. The relationship of clinical variants of STD with the selected groups was revealed. The diagnosis of schizotypal personality disorder was significantly more often (66%) diagnosed in patients from group 1 compared with groups 3 and 5. In group 2, this diagnosis was established in a third of cases. The diagnosis of the psychopathic variant of STD was predominant in patients with the onset of the disorder between 7 and 13 years of age. The neurosis-like variant had a clear tendency to become more frequent with older age, reaching statistically significant differences in group 5 compared to group 1. The age of onset and duration of persistence of psychopathological disorders determines the level of negative changes that have formed at the stage of the disease preceding the onset of distinct clinical symptoms of STD. Age at onset determines the predominant positive disorder.