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Jornal de Pediatria

Print version ISSN 0021-7557

J. Pediatr. (Rio J.) vol.80 no.5 Porto Alegre  2004

http://dx.doi.org/10.1590/S0021-75572004000600019 

LETTERS TO EDITOR

 

Functional psychosis in childhood and adolescence

 

Dear Editors,

We read with great interest the Supplement 2 of the Jornal de Pediatria about Mental Health, especially the paper entitled "Functional Psychosis in Childhood and Adolescence" by Tengan & Maia.1 They discussed in this text an important issue in child psychiatry, the distinction between childhood-onset schizophrenia and autism.

Since the works of Kolvin & Rutter,2 autism was reliably separated from early-onset schizophrenia, becoming one of the best-validated distinctions in child psychiatry, but a striking feature of childhood-onset schizophrenia samples relative to adult-onset schizophrenia is the higher rate of early language, social, and motor developmental abnormalities. Pre-morbid social impairment was the most common feature, present in 50-87% of childhood-onset schizophrenia cases across five independent research centers.3

The full syndromes of schizophrenia and autism seem to be distinct, however it is possible that a subgroup of those with childhood-onset schizophrenia and those with autism share a similar genetic compound.4 Yan et al.5 reported a balanced translocation between chromosomes 1 and 7 in a boy with childhood-onset schizophrenia. The breakpoints were at the short arm of chromosome 1 (region p22) and at the long arm of chromosome 7 (region q21). This report is very interesting given a previous case of chromosomal rearrangement involving chromosomes 1, 7 and 21 in an autistic boy where the breakpoint at chromosome 1 was also in the region p22.6 These findings make the breakpoints of chromosomes 1 and 7 likely sites for molecular genetic studies. These regions may present genes which may be involved in the etiopathology of childhood-onset schizophrenia and autism, thus these two disorders, apparently so distinct, may present a common biological basis in some cases, consisting of phenotypic variants of a very early onset illness.3

 

Quirino Cordeiro

Postgraduate Program, Department of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
E-mail:E-mail: qcordeiro@yahoo.com

Homero Vallada

Associate professor, Department of Psychiatry, School of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil.
E-mail:E-mail: hvallada@usp.br

 

References

1. Tengan K, Maia AK. Functional psychosis in childhood and adolescence. J Pediatr (Rio J). 2004;80(2 Suppl):S3-10.

2. Rutter M. Childhood schizophrenia reconsidered. J Autism Child Schizophr. 1972;2:315-7.

3. Sporn AL, Addington AM, Gogtay N, Ordoñez AE, Gornick M, Clasen L, et al. Pervasive developmental disorder and childhood-onset schizophrenia: comorbid disorder or a phenotypic variant of a very early onset illness? Biol Psychiatry. 2004;55:989-94.

4. Thapar A, Scourfield J. Childhood disorders. In: McGuffin P, Owen M, Gottesman II, editors. Psychiatric Genetics and Genomics. 1st ed. New York: Oxford University Press; 2002. p. 147-180.

5. Yan WL, Guan XY, Green ED, Nicolson R, Yap TK, Zhang J, et al. Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21. Am J Med Genet. 2000;96:749-53.

6. Lopreiato JO, Wulfsberg EA. A complex chromosome rearrangement in a boy with autism. J Dev Behav Pediatr. 1992;13:281-3.

5. Yan WL, Guan XY, Green ED, Nicolson R, Yap TK, Zhang J, et al. Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21. Am J Med Genet. 2000;96:749-53.