schizophreniaetiologyarticleAJP1999

schizophreniaetiologyarticleAJP1999 - Regular Articles...

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Am J Psychiatry 156:4, April 1999 525 Regular Articles Relationship Between Childhood Behavioral Disturbance and Later Schizophrenia in the New York High-Risk Project G. Paul Amminger, M.D., Sky Pape, Donald Rock, Ph.D., Simone A. Roberts, B.A., Salome Looser Ott, Ph.D., Elizabeth Squires-Wheeler, Ph.D., Clarice Kestenbaum, M.D., and L. Erlenmeyer-Kimling, Ph.D., D.Sc. Objective: An association between childhood behavioral disturbance and adulthood schizophrenia has been seen previously in retrospective or follow-back studies and in pro- spective studies. The authors examined the relationship between childhood behavioral problems and adulthood schizophrenia-related psychoses. Because a high rate of child- hood behavioral problems is known to be associated with adult substance abuse, these analyses controlled for substance abuse. Method: The subjects of this investigation (N= 185) were offspring of parents with schizophrenia or affective disorder and of normal par- ents from the New York High-Risk Project (sample A). Data on childhood behavioral prob- lems were obtained in a parent interview at initial assessment in 1971–1972. Adulthood outcomes (schizophrenia-related psychoses, affective disorders, anxiety disorders, sub- stance abuse) were based on lifetime axis I diagnoses according to the Research Diagnos- tic Criteria. Results: Substance abuse had a significant interaction with the clinical out- come groups. In subjects without substance abuse, those with schizophrenia-related psychoses had exhibited significantly more behavioral problems as children than had adult offspring with affective or anxiety disorder or with substance abuse only or no disorder. Conclusions: These results support the view that schizophrenia-related psychoses can be followed back to early behavioral disturbances. The confounding effects of substance abuse should be statistically controlled in studies of longitudinal associations between childhood behavioral disturbance and axis I outcomes. (Am J Psychiatry 1999; 156:525–530) O ne of the major goals of schizophrenia research in the past three decades has been the identification of precursor symptoms and areas of dysfunction before the manifestation of schizophrenia. Psychological and neurodevelopmental abnormalities in preschizo- phrenic persons have repeatedly been described, and it is now well established (1–3) that early signs of the dis- order can be found during infancy. Presumably, these neuropsychological domains influence the individual’s interpersonal functioning and behavior. Consistent with this assumption are results from earlier investiga- tions using retrospective designs (e.g., reference 4) or follow-back designs (e.g., references 5–7) that have shown behavioral deviations in children who later de- veloped schizophrenia, years before the onset of overt psychosis. Prospective studies (8, 9) have confirmed as- sociations between childhood developmental charac- teristics, including behavioral abnormalities, and
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schizophreniaetiologyarticleAJP1999 - Regular Articles...

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