Neuropsychological deficits in children associated with increased familial risk for schizophrenia.

By studying neuropsychological performance in children genetically at-risk for schizophrenia, greater understanding may be obtained regarding the developmental processes of schizophrenia and associated cognitive weaknesses. A variety of cognitive deficits in genetically at-risk children have been reported. The present study was designed to examine cognitive tasks that have traditionally differentiated children genetically at-risk for schizophrenia (e.g. working memory) from normal children, while also assessing abilities that have received scant attention in this population. Aspects of emotional perception, verbal abilities, inhibition, visuo-spatial skills, and working memory were assessed in children of schizophrenic parents and normal children. Significant differences in performances were identified in at-risk children on measures of verbal skills, working memory and inhibition. Findings suggest that children genetically at-risk for developing schizophrenia exhibit neurocognitive weaknesses generally consistent with those noted in the literature. However, inhibition also appeared to be a cognitive process that significantly differentiated the groups. The possibility of a developmental expression of neurocognitive deficits is discussed.

Creating school-age versions of semistructured interviews for the prodrome to schizophrenia: lessons from case reviews.

There is an increasing emphasis on identifying individuals with schizophrenia earlier and earlier in their disease process, with the assumption that earlier identification translates into earlier treatment, which translates into improved outcome. Unfortunately, one age cohort, children under 13 years of age, have been excluded from this critical alteration in clinical intervention strategy, and its associated improved clinical outcome. One of the barriers to inclusion of younger children is the lack of knowledge about diagnostic issues related to attenuated psychotic symptoms in this age sample. This report focuses on our experience with evaluating attenuated psychotic symptoms in young children, in particular subthreshold hallucinations and delusions, using semistructured interviews. The inclusion of both Caregiver and Child report sections and the addition of concrete, detailed examples of clear-conscience, non-stress-related subthreshold psychotic symptoms are likely to be necessary.

Admixture analysis of smooth pursuit eye movements in probands with schizophrenia and their relatives suggests gain and leading saccades are potential endophenotypes.

Abnormalities during a smooth pursuit eye movement task (SPEM) are common in schizophrenic patients and their relatives. This study assessed various components of SPEM performance in first-degree unaffected relatives of schizophrenic patients. One hundred individuals with schizophrenia, 137 unaffected first-degree relatives, and 69 normal controls completed a 16.7 degrees/s SPEM task. Smooth pursuit gain, catch-up saccades (CUS), large anticipatory saccades, and leading saccades (LS) were identified. Groups were compared with parametric and admixture analyses. Schizophrenic patients performed more poorly than unaffected relatives and normals on gain, CUS, and LS. Unaffected relatives were more frequently impaired than normals only on gain and LS. Relatives of childhood-onset and adult-onset probands had similar impairments. Gain and frequency of leading saccades may be genetic endophenotypes in childhood-onset and adult-onset schizophrenia.