A esquizofrenia ao longo da infância

Bursztejn, Claude

doi:10.1590/1415-47142005003003

Resumos

As pesquisas sobre os grupos “de alto risco” (filhos de pais esquizofrênicos), assim como os estudos prospectivos na população geral, mostram que os futuros esquizofrênicos apresentam, comparativamente aos sujeitos-controle, atrasos do desenvolvimento psicomotor, déficits cognitivos e algumas particularidades comportamentais. Tais dados parecem confirmar a idéia segundo a qual a esquizofrenia corresponderia a um distúrbio neurodesenvolvimental cuja expressão varia ao longo da vida. As especificidades clínicas e evolutivas dos raros casos de esquizofrenia iniciando-se na infância levam alguns autores a pensar que se trataria de uma entidade específica e cujo pertencimento ao “espectro autista” necessita ainda ser estudado.

Criança; expressividade psicopatológica; esquizofrenia; espectro autista

Los trabajos de investigación sobre grupos “de alto riesgo” (hijos de padres esquizofrénicos), así como los estudios prospectivos en la populación general, muestran que los futuros esquizofrénicos presentan, comparativamente a los sujetos-control, atrasos del desarrollo motor, déficit cognitivos y algunas particularidades de comportamiento. Esos datos parecen confirmar la idea de que la esquizofrenia correspondería a un disturbio de neuro-desarrollo cuya expresión varia a lo largo de la vida. Las especificidades clínicas y evolutivas de los raros casos de esquizofrenia que se inician en la infancia llevan algunos autores a pensar que se trataría de una entidad específica y cuya pertenencia al “espectro autista” necesita ser todavía estudiado.

Niños; expresividad psicopatológica; esquizofrenia; espectro autista

Les recherches sur les groupes “à haut risque” (enfants de parents schizophrènes), ainsi que des enquêtes prospectives en population générale montrent que les futurs schizophrènes présentent, comparativement aux témoins, des retards du développement psychomoteur, des déficits cognitifs et certaines particularités comportementales. Ces données semblent confirmer l’idée selon laquelle la schizophrénie correspondrait à un trouble neuro-développemental dont l’expression varie au cours de la vie. Les spécificités cliniques et évolutives des rares cas de schizophrénie débutant dans l’enfance amènent certains auteurs à penser qu’il s’agirait d’une entité spécifique et dont l’appartenance au “spectre autistique” demande encore à être envisagée.

Enfant; expressivité psychopathologique; schizophrénie; spectre autistique

The researches on “high risk” groups (children of schizophrenic parents), just like the prospective studies in the general population, show that the future schizophrenics present, comparatively to the “control-subjects”, delays on their psychomotor development, cognitive deficits and some behavioral particularities. Such data seem to confirm the idea from which the schizophrenia would correspond to a neurodevelopmental disturb whose expression varies along one’s life. The clinical and developmental intricacies of the rear cases of schizophrenia that begin during childhood make some authors think that it could be related to a particular entity and whose belonging to the “autistic spectrum” still needs to be researched.

Child; psychological expressivity; schizophrenia; autistic spectrum

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Referências

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Datas de Publicação

Publicação nesta coleção
Jul-Sep 2005

Histórico

Recebido
Out 2004
Aceito
Ago 2005

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[1] ALAGHBAND-RAD, J.; MCKENNA, K.; GORDON, C. T.; ALBUS, K. E.; HAMBURGER, S. D.; RUMSEY, J. M.; FRAZIER, J. A.; LENANE, M. C.; RAPOPORT, J.-L. Childhood-onset schizophrenia: The severity of premorbid course. Journal of the American Academy of Child & Adolescent Psychiatry, n. 34, p. 1273-83, 1995.

[2] ASARNOW, J. R. & BEN-MEIR, S. Children with schizophrenia spectrum and depressive disorders: A comparative study of premorbid adjustment, onset pattern and severity of impairment. Journal of Child Psychology and Psychiatry, n. 29, p. 477-88, 1988.

[3] ASARNOW, J. R.; TOMPSON, M. C.; GOLDSTEIN, M. J. Childhood onset schizophrenia: A follow-up study. Schizophrenia Bulletin, n. 20, p. 599-617, 1994.

[4] BAILER, J.; BRAUER, W.; REY, E. R. Premorbid adjustment as predictor of outcome in schizophrenia: Results of a prospective study. Acta Psychiatr. Scand, n. 93, p. 368-77, 1996.

[5] BAUM, K. M. & WALKER, E. F. Childhood behavioral precursors of adult symptom dimensions in schizophrenia. Schizophen. Res, n. 16, 111-20, 1995.

[6] CANNON, M.; JONES, P.; HUTTUNEN, M. O.; TANSKANEN, A.; HUTTUNEN, T.; RABE-HESKETH, S.; MURRAY, R. M. School performance in Finnish children and later development of schizophrenia: A population-based longitudinal study. Archives of General Psychiatry, v. 56, n. 5, p. 457-63, May 1999.

[7] CAPLAN, R. Thought disorder in childhood. Journal of the American Academy of Child & Adolescent Psychiatry, n. 33, p. 605-15, 1994.

[8] CRAIG, T. J.; BROMET, E. J.; FENNIG, S.; TANENBERG-KARANT, M.; LAVELLE, J.; GALAMBOS, N. Is there an association between duration of untreated psychosis and 24-month clinical outcome in a first-admission series? Am. J. Psychiatry, n. 157, p. 60-6, 2000.

[9] CROW, T. J.; MCMILLAN, J. F.; JOHNSON, A. L.; JOHNSTONE, E. C. A randomised controled trial of prophylactic neuroleptic treatment. Brit. J. Psychiatry, n. 148, p. 120-27, 1986.

[10] DONE, D. J.; CROW, T. F.; JOHNSTONE, E. C.; SACKER, A. Childhood antecedents of schizophrenia and affective illness: Social adjustment at ages 7 and 11. Brit. Med. J., n. 309, p. 699-703, 1994.

[11] EGGERS, C. Course and prognossis of childhood schizophrenia. Journal of Autism & Childhood Schizophrenia, n. 8, p. 21-35, 1978.

[12] ERLENMEYER-KIMLING, L.; ADAMO, U. H.; ROCK, D.; ROBERTS, S. A.; BASSETT, A. S.; SQUIRES-WHEELER, E.; CORNBLATT, B.; ENDICOTT, J.; PAPE, S.; GOTTESMAN, I. I. The New York high risk project: Prevalenceand comorbidity of axis I disorders in offspring of schizophrenic parents at 25 year of follow-up. Archives of General Psychiatry, n. 54, p. 1096-102, 1997.

[13] ERLENMEYER-KIMLING, L.; ROCK, D.; ROBERTS, S. A.; JANAL, M.; KESTENBAUM, C.; CORNBLATT, B.; ADAMO, U. H.; GOTTESMAN, I. I. Attention, memory, and motor skills as childhood predictors of schizophrenia-related psychoses: The New York high risk project. Am. J. Psychiatry, n. 157, p. 1416-22, 2000.

[14] ERLENMEYER-KIMLING, L.; SQUIRES-WHEELER, E.; ADAMO, U. H.; BASSETT, A. S.; CURNBLATT, B.; KESTENBAUM, C.; ROCK, D.; ROBERTS, S. A.; GOTTESMAN, I. I. The New York high risk project: Psychoses and cluster. A personality disorders in offspring of schizophrenic parents at 23 years of follow-up. Archives of General Psychiatry, n. 52, p. 857-65, 1995.

[15] FENNIG, S.; SUSSER, E. S.; PILOWSKY, D. J.; FENNIG, S.; BROMET, E. J. Childhood hallucinations preceding the first psychotic episode. J. Nerv. Ment. Dis., n. 185, p. 115-7, 1997.

[16] FISH, B. Neurobiologic antecedents of schizophrenia in children: Evidence for an inherited, congenital neurointegrative defect. Archives of General Psychiatry, n. 34, p. 1297-1313, 1977.

[17] FISH, B.; MARCUS, J.; HANS, S. L.; AUERBACH, J. G.; PERDUE, S. Infants at risk for schizophrenia: Sequelae of a genetic neurointegrative defect. A review and replication analysis of pandysmaturation in the Jerusalem infant development study. Archives of General Psychiatry, n. 49, p. 221-35, 1992.

[18] FOERSTER, A.; LEWIS, S. W.; OWEN, M. J.; MURRAY, R. M. Low birth weight and a family history of schizophrenia predict poor premorbid functioning in psychosis. Schipophr. Res., n. 5, p. 13-20, 1991.

[19] FRANKE, P.; MAIER, W.; HARDT, J.; HAIN, C. Cognitive functining and anhedonia in subjects at risk for schizophrenia. Schizoph. Res., n. 10, p. 77-84, 1993.

[20] GLASHAN, T. H. & JOHANNESSEN, J. O. Early detection and intervention with schizophrenia: rationale. Schizophrenia Bulletin, n. 22, p. 201-22, 1996.

[21] GREEN, W.; PADRON-GAYOL, M.; HARDESTY, A.; BASSIRI, M. Schizophrenia with childhood onset: A phenomenological study of 38 cases. Journal of the American Academy of Child & Adolescent Psychiatry, n. 31, p. 968-76, 1992.

[22] HAFNER, H.; HAMBRECHT, M.; LOFFLER, W.; MULLK-JORGENSE, P.; RIECHER-ROSSLER, A. Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle. Psychol. Med., n. 28, p. 351-65, 1998.

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