Longitudinal observations of biological deviations in a schizophrenic infant.

Abstract

The longitudinal observations made on this child, who is clinically schizophrenic at 5½ years, show that the normal progress of neurological and physiological maturation [refer Source PDF] was disrupted as early as 1 month of age. Biological development differed significantly from the other infants studied by the author, from norms of growth and development previously established on hundreds of children by Gesell and others, and from the usual forms of retarded or precocious development. The following deviations were discussed: 1. The presence of an abnormal torpid state in the first months of life, 2. A severe but transient lag and disorganization in postural-locomotor development, and 3. Physiological disturbances which paralleled the transient neurological disturbances, including retarded physical growth and autonomic instability. These biological manifestations antedated the anxiety and psychological symptoms, and appeared to be intimately related to the later clinical manifestations of schizophrenia. A preliminary study such as this raises more questions than it answers. We plan to study a much larger number of infants to determine the critical limits beyond which erratic development may be the first sign of schizophrenia, as distinguished from the spectrum of relatively benign individual variations; and to study how different patterns of maternal care and early physiological support can modify this development. The capacity of different individuals to maintain psychological integrity in the face of stress is often attributed to elusive qualities we summarize as ego strength. It would appear that there is a related variation in the capacity for integration in the early neurophysiological development of infants. Differences in the growing organization of alertness and muscle tonus, the progression of postural control, physical growth and autonomic stability lend themselves to quantitative measurement and analysis. We believe that further study of these individual differences in early neurological integration should increase our understanding of the factors making for mental health and disease.