Y a-t-il des particularités cliniques au délire exprimé lors de schizophrénies secondaires à une psychose infantile ?

Abstract

Children with Pervasive Developmental Disorders who become schizophrenic during their adolescence are usually patients whose IQ is normal or high and who have a linguistic level which enables them to express certain symptoms required by international classifications to establish the diagnosis of schizophrenia: i.e. delusions and hallucinations. Within the group of schizophrenic disorders, we try here to distinguish: 1/ Schizophrenic patients within whom a schizophrenic process has appeared spontaneously during adolescence without any psychotic episodes in childhood ( “de novo” schizophrenia). 2/ Those patients within whom the adolescent process breaks down on a schizophrenic manner; what was formely compensated for gives way to a serious early developmental disorder (secondary schizophrenia). Starting from a more precise examination of the schizophrenic delusional demonstrations, we endeavor to show how common signs regarding the descriptive criteria adopted by international classifications for the diagnosis of schizophrenia hide in fact fundamental psychopathological differences. In these cases the change of the expression of the symptoms between infancy and adolescence are insufficiently clear to define pathological continuity between childhood psychoses and some forms of schizophrenia in adolescence. Within the final common path of typical schizophrenic features, are thus determined radically distinct dynamic organizations which must be taken into account for the multifocal treatments indicated in these pathologies. These considerations are likely to modify our point of view regarding the concept of vulnerability with a different value for each of the two psychopathological types we define.