High-Risk-Kinder für Schizophrenie eine Übersicht

Abstract

Since the early 1950s high-risk studies have systematically investigated the offspring of schizophrenics. The majority of high-risk children had schizophrenic mothers, to a lesser degree schizophrenic fathers and even more seldom schizophrenic siblings. Family studies revealed that disturbances from the so called spectrum - also play a role for the genetic proliferation of schizophrenic diseases. High-risk studies must be carefully planned for an extremely long future. Schizophrenic mothers are difficult co-workers. The drop-out rate is high. Scientists investigating healthy children are confronted with criticism from the public. Last but not least after many years of follow-up one wishes to have taken into consideration scientific means that were not available at the beginning of the study. Notwithstanding these hardships high-risk studies at various centres all over the world have meanwhile been going on for several decades, the former children have become grown-ups, have reached and passed the critical age for schizophrenia outbreak and a vast amount of data have been collected and contribute to our knowledge of the disease. Already at a very young age high-risk children of schizophrenia differ in many aspects from their low-risk peers: physically, mentally, behaviourally and in the ways they are being brought up. They are underweight, show physical abnormalities, reach important developmental stages later in life, are inclined to isolate themselves, are more depressed, have worse school-careers, show more forensic problems and have an early history of psychiatric contacts. Terms like pandevelopmental retardation or pandysmaturation have become common to describe the problem. - Growing up with a schizophrenic mother has many disadvantages for these children. Schizophrenic mothers are often socially marginalised, they show less empathy, understanding and spontaneity, their educational style has been described as poorer, the family climate is chaotic, neglect and physical abuse are not infrequent. High-risk children have a tendency to make themselves invisible. - Among the high-risk population one does also find children that are especially gifted, talented and creative, with rich fantasies and later on successful as adults. Much is known about risk factors that eventually might lead to the outbreak of the disease, though many of them being unspecific: all irregularities, disturbances and problems during pregnancy, birth and childhood have a positive correlation with later schizophrenia, the earlier they happen and the more severe they are, the greater the risk. Traumata during the 6th gestational month seem to bear most unfortunate consequences. -Cultural, social and familial factors have also some impact on later schizophrenia. Father's age over 55 at the time the children are born is considered unfortunate, such as an early outbreak of mother's disease, cannabis-abuse of the mother and a mother's body-mass index of over 30. Families with a high level of disturbed communication (i.e. conflicts between parents and children, lack of empathy, breaches in inner familial communication, a narrowing milieu and problems with borders) seem to contribute to the outbreak of schizophrenia in the offspring. Some knowledge is available about protective factors. Major interest focussed on environmental influence, detrimental as well as protective.