Week 2 Flashcards
Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia
Study Objective
To examine social and neuromotor behaviors in children who later developed schizophrenia compared to those who did not.
Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia
Study Design
Longitudinal study using childhood videotapes of Danish children aged 11–13 in 1972, with adult diagnostic follow-up in 1991.
Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia
Key Findings
- Preschizophrenia children showed reduced sociability and, in boys, neuromotor deficits.
- Differences were specific to schizophrenia, not other psychiatric disorders.
Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia
Neuromotor Deficits
Poor motor coordination and increased involuntary movements observed in childhood predicted schizophrenia in adulthood.
Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia
Conclusions
Findings support a neurodevelopmental hypothesis of schizophrenia, with social and motor deficits as early precursors.
Childhood Precursors of Schizophrenia
Neuromotor Abnormalities
Children who later developed schizophrenia displayed higher rates of neurological “soft signs” like involuntary movements, poor coordination, and dyskinesia.
Childhood Precursors of Schizophrenia
Social Behavior Deficits
Children who developed schizophrenia showed reduced sociability, fewer smiles, and less vocal interaction compared to peers.
Childhood Precursors of Schizophrenia
High-Risk Sample
Children with a parent diagnosed with schizophrenia had increased likelihood of developing schizophrenia-related disorders.
Childhood Precursors of Schizophrenia
Gender Differences
Boys showed more pronounced neuromotor deficits, while social impairments were observed across genders.
Childhood Precursors of Schizophrenia
Videotape Coding Variables
Included measures of smiles, laughter, involuntary hand movements, nystagmus-like eye movements, and abnormal motor signs.
Childhood Precursors of Schizophrenia
Strengths of the Study
- Prospective design with standardized videotaping protocols.
- Long-term follow-up (20 years).
- Use of DSM-III-R criteria for adult psychiatric diagnoses.
Childhood Precursors of Schizophrenia
Study Limitations
- Small sample size for schizophrenia group (N=16).
- Moderate interrater reliability for neuromotor measures.
- Missing videotape data for some subjects.
Childhood Precursors of Schizophrenia
Longitudinal Results
Differences in childhood behaviors were consistent with adult diagnostic outcomes, supporting a neurodevelopmental hypothesis of schizophrenia.
Epidemiology of Schizophrenia: Global Insights
Global Prevalence
Schizophrenia affects 1.4–4.6 per 1000 individuals globally, with small variations across populations.
Epidemiology of Schizophrenia: Global Insights
Incidence Rates
Schizophrenia incidence is 0.16–0.42 per 1000 annually, with minimal global variation.
Epidemiology of Schizophrenia: Global Insights
Better Outcomes in Developing Countries
Patients in developing nations have higher remission rates and lower social impairment, often without sustained medication.
Epidemiology of Schizophrenia: Global Insights
Key Risk Factors
Genetic predisposition, early neurodevelopmental issues, and environmental interactions are primary contributors.
Epidemiology of Schizophrenia: Global Insights
Sex Differences
Earlier onset in men; women show better premorbid functioning, outcomes, and fewer brain abnormalities.
Epidemiology of Schizophrenia: Global Insights
Schizophrenia Prevalence
Occurs in 1.4–4.6 per 1000 people globally, with a consistent prevalence across most populations but notable exceptions, such as isolated or endogamous communities.
Epidemiology of Schizophrenia: Global Insights
Incidence Rates
Annual incidence ranges from 0.16 to 0.42 per 1000 individuals, with “broad” criteria (ICD-9) showing higher rates than restrictive diagnostic criteria (DSM or ICD-10).
Epidemiology of Schizophrenia: Global Insights
Better Outcomes in Developing Countries
Schizophrenia patients in developing nations (India, Nigeria, Colombia) experience higher remission rates, better social integration, and less chronic disability compared to those in developed countries.
Epidemiology of Schizophrenia: Global Insights
Potential Factors for Better Outcomes in Developing Countries
Differences may involve acute illness onset, supportive social networks, and reduced stigma, though environmental and genetic interactions are not fully understood.
Epidemiology of Schizophrenia: Global Insights
WHO Ten-Country Study Findings
- Remission rates were higher in developing countries (62.7%) compared to developed countries (36.8%).
- Fewer patients in developing countries required long-term hospitalization or antipsychotic medication.
Epidemiology of Schizophrenia: Global Insights
Sex Differences in Schizophrenia
Men: Earlier onset (by 4–5 years), worse premorbid functioning, and more brain abnormalities.
Women: Better outcomes and higher remission rates, especially post-menopause.