Predictive symptomatology, course and outcome in first-episode schizophrenia

Abstract

The mechanism by which the prepsychotic state switches into psychosis is not understood, and little is known about the structure and functioning of the central nervous systems of individuals destined to become schizophrenic. Evidence from the National Child Development Study in Great Britain suggests that children destined to become schizophrenic in adulthood show differences from controls at the age of 7 years (greater anxiety for acceptance, hostility and inconsequential behavior). The Edinburgh High-Risk Study of subjects aged 16-24 years with at least two dose family members suffering from schizophrenia hopes to answer questions about predictive symptomatology and the onset of psychosis. Preliminary results suggest that subjects from the high-risk group have brain structural characteristics lying between those of normal controls and established schizophrenics, and show more abnormalities of executive functioning, reported sensitivity, abnormal effect and observed disorganization of speech than controls. More will be known about the effectiveness of these potential stuctural, neuropsychological and psychopathological predictors when the study is complete and subjects in the high-risk group have had time to become ill.