Early-Onset Schizophrenia in a paediatric population of French psychiatric and medico-social care centres: A cross sectional study.

BACKGROUND: Early-Onset Schizophrenia (EOS) is rare but severe mental health disorder in children and adolescents. Diagnosis of schizophrenia before the age of 18 years remains complex and challenging, especially in young children. In France, there are no recent reliable epidemiological data about the prevalence of EOS. The present study evaluates the EOS rate in a target clinical population of children and adolescents in psychiatric and medico-social care centres in the South-East of France. METHODS: Psychiatric and medico-social centres for children and adolescent in the geographical area have been contacted, and after receiving their agreement to participate in the study, eligible patients corresponding to inclusion criteria were selected based on patients' medical records. Main inclusion criteria were age 7 to 17 years and intelligence quotient > 35. EOS categorical diagnosis was assessed by Kiddie-SADS Present and Lifetime psychosis section. RESULTS: 37 centres participated and 302 subjects have been included in the study. The main result was the categorical diagnosis of EOS in 27 subjects, corresponding to a rate of 8.9% in the study population. Half of the patients presented mild to moderate intellectual deficiency. Interestingly, only 2.3% had a diagnosis of schizophrenia spectrum disorder noted in their medical records before standardized assessment. CONCLUSIONS: The results of the study highlight the importance of using a standardized diagnostic tool for the diagnosis of schizophrenia in the paediatric population. In fact, EOS might be underdiagnosed in children and adolescents with neurodevelopmental disorders and subnormal cognitive functioning. TRIAL REGISTRATION: NCT01512641. Registered 19 January 2012; https://clinicaltrials.gov/ct2/show/NCT01512641.

Impact of an implicit social skills training group in children with autism spectrum disorder without intellectual disability: A before-and-after study.

INTRODUCTION: Children with Autism Spectrum Disorders (ASDs) have problems with social skills. Social skills training groups are among the proposed therapeutic strategies, but their efficacy still needs to be evaluated. OBJECTIVE: To evaluate the efficacy of an implicit social skills training group in children with ASDs without intellectual disability. METHODS: A before-and-after study of children with ASD without intellectual disability was conducted in a child psychiatry day hospital, where they participated in an implicit group with cooperative games. Their social skills were assessed using the Social-Emotional Profile (SEP), the Childhood Autism Rating Scale (CARS), and the empathy quotient (EQ) before and after 22 weeks. RESULTS: Six patients aged 9 to 10 years old were evaluated. A significant increase in overall adaptation and social skills (median 8 and 7.7 points) in the SEP was demonstrated in addition to a significant reduction in the CARS score (median: 4 points), including in the field of social relationships. The EQ increased two-fold. DISCUSSION­CONCLUSION: This implicit group improved the children's social skills. It would be interesting to evaluate the maintenance of these skills over time, examine more widespread results, and compare implicit and explicit groups.

Catatonia and Autoimmune Conditions in Children and Adolescents: Should We Consider a Therapeutic Challenge?

OBJECTIVE: Catatonia as a result of autoimmune conditions offers new therapeutic opportunities for patients that child and adolescent psychiatrists should consider. However, the diagnosis is sometimes challenging when an autoimmune signature is not identified. METHODS: In this study, we aim to summarize seven cases from a 20-year series of 84 youths with catatonia, including three cases that represented a diagnostic challenge because of the absence of positive autoimmune testing. RESULTS: Immunosuppressive/modulatory treatment improved catatonic and psychotic features in all cases. CONCLUSION: To facilitate treatment decision-making, we propose a causality assessment score and a treatment algorithm, which may help clinicians consider whether an autoimmune condition is associated with catatonia.

Attention to low- and high-spatial frequencies in categorizing facial identities, emotions and gender in children with autism.

This study was aimed at investigating face categorization strategies in children with autistic spectrum disorders (ASD). Performance of 17 children with ASD was compared to that of 17 control children in a face-matching task, including hybrid faces (composed of two overlapping faces of different spatial bandwidths) and either low- or high-pass filtered faces. Participants were asked to match faces on the basis of identity, emotion or gender. Results revealed that children with ASD used the same strategies as controls when matching faces by gender. By contrast, in the identity and the emotion conditions, children with ASD showed a high-pass bias (i.e., preference for local information), contrary to controls. Consistent with previous studies on autism, these findings suggest that children with ASD do use atypical (local-oriented) strategies to process faces.