Abstract
Childhood-onset schizophrenia (COS) refers to schizophrenia with onset of psychotic symptoms prior to a child's 13th birthday. Optimal treatment likely includes family-based services supplementing antipsychotic pharmacotherapy. However, family-based services can require adjustment based on parental psychopathology; there has been little literature exploring the frequency or type of psychopathology seen in parents of COS cases. This report includes the results of a structured psychiatric evaluation on 80 parents of a COS case with comparison to a sample of 304 parents. Having a child with psychosis and being of minority racial/ethnicity status increased risk for psychiatric illness. Psychotic disorders (15% vs. 5%), mood disorders (54% vs. 27%), anxiety disorders (30% vs. 18%), and substance use disorders (49% vs. 31%) were all increased in the parents with a psychotic child. Psychiatric illness is common in parents of a child with COS and will need to be considered as family-based services for COS are developed.
Highlights
Childhood-onset Schizophrenia (COS) is defined by the same Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria as its adult counterpart, differentiated only by onset prior to a child’s 13th birthday.[1]
Rates of psychotic disorders (15% vs. 5%), mood disorders (54% vs. 27%), anxiety disorders (30% vs. 18%), and substance use disorders (49% vs. 31%) are higher in COS-parents than in comparison parents
Previous studies of children and adolescents with bipolar disorder have demonstrated that prognosis closely correlates with measures of family functioning in areas of communication, expressed emotion, contingency planning, and psychoeducation.[27]
Summary
Childhood-onset Schizophrenia (COS) is defined by the same Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria as its adult counterpart, differentiated only by onset prior to a child’s 13th birthday.[1]. Adoption studies have found that families with significant levels of dysfunction tend to lead to a poorer prognosis in children who are already genetically susceptible to though not yet diagnosed with schizophrenia.[18] While the link between family dysfunction and mental illness has not been made in the family function scale utilized by Tienari et al.,[18] many of the scale’s domains overlap with common clinical characteristics of a variety of Axis I mental illnesses. Previous studies that examine parental phenotypes of COS children have tended to approach the topic from a genetic or inheritability standpoint and rarely look beyond psychotic diagnoses or physiologic findings in first-degree relatives.[19]
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