Neuropsychological Deficits in the Prodromal Phase and Course of an Early-Onset Schizophrenia

2014 ◽  
Vol 42 (3) ◽  
pp. 167-176 ◽  
Author(s):  
Vanessa Puetz ◽  
Thomas Günther ◽  
Berrak Kahraman-Lanzerath ◽  
Beate Herpertz-Dahlmann ◽  
Kerstin Konrad
Keyword(s):  
Verbal Memory ◽  
Early Onset ◽  
Neuropsychological Functioning ◽  
Neuropsychological Testing ◽  
Clinical Situation ◽  
Adolescent Male ◽  
Antipsychotic Treatment ◽  
Early Onset Schizophrenia ◽  
Prodromal Phase ◽  
Illness Onset

Objectives: Although clear advances have been achieved in the study of early-onset schizophrenia (EOS), little is known to date about premorbid and prodromal neuropsychological functioning in EOS. Method: Here, we report on a case of an adolescent male with EOS who underwent neuropsychological testing before and after illness onset. Results: Marked cognitive deficits in the domains of attention, set-shifting, and verbal memory were present both pre-onset and during the course of schizophrenia, though only deficits in verbal memory persisted after illness-onset and antipsychotic treatment. Conclusion: The findings of this case study suggest that impairments in the verbal memory domain are particularly prominent symptoms of cognitive impairment in prodromal EOS and persist in the course of the disorder, which further demonstrates the difficult clinical situation of adequate schooling opportunities for adolescent patients with EOS.

Use of atypical antipsychotics in early onset schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 324-324
Author(s):  
M. Marin Mayor ◽  
N. Martinez Martin ◽  
E. Verdura Vizcaino ◽  
R.A. Codesal Julian
Keyword(s):  
Side Effects ◽  
Children And Adolescents ◽  
Early Onset ◽  
Atypical Antipsychotics ◽  
Metabolic Effects ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Childhood And Adolescence ◽  
Early Onset Schizophrenia ◽  
Children And Adolescent

IntroductionChildhood or Early Onset Schizophrenia (EOS), defined as the onset of psychotic symptoms before the thirteenth birthday, represents a rare, clinically severe variant, associated with significant chronic functional impairment and poor response to antipsychotic treatment. Despite of that, in clinical practice, atypical agents have become the treatment of choice in patients with EOS.AimsTo review the different pharmacological strategies, in which an atypical antipsychotic was used in the management of EOS in childhood and adolescence.MethodsWe conducted a literature search of articles related to the use of atypical antipsychotics in children and adolescents with EOS in the last 20 years from the Medline database.ResultsSeveral atypical antipsychotics, such as Risperidone, Olanzapine, Quetiapine, Aripiprazol and Clozapine were consistently found to reduce the severity of psychotic symptoms in EOS when compared to placebo. Although Clozapine has demonstrated to be more efficacious than other atypical and typical antipsychotics, it remains the medication of last resort due to its profile of side effects. Finally, in general, children and adolescent have a higher risk of extrapyramidal symptoms, akathisia, prolactin elevation, sedation and metabolic effects of atypical antipsychotics than adults.ConclusionsAntipsychotics are the mainstay of treatment of EOS. Randomized controlled trials suggest a trend to superior efficacy for atypical antipsychotics over classic antipsychotic. Children and adolescents trend to be more sensible to antipsychotic side effects. Clinicians should be aware of this problem and be careful when monitoring this type of treatment.

Comparison of Neuropsychological Functioning Between Adults With Early- and Late-Onset DSM-5 ADHD

2017 ◽  
Vol 24 (1) ◽  
pp. 29-40 ◽  
Author(s):  
Yu-Ju Lin ◽  
Susan Shur-Fen Gau
Keyword(s):  
Early Onset ◽  
Adult Adhd ◽  
Spatial Working Memory ◽  
Late Onset ◽  
Neuropsychological Functioning ◽  
Neuropsychological Testing ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Signal Detectability

Objective: We aimed to compare the visually dependent neuropsychological functioning among adults with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD who recalled symptom onset by and after age 7 and non-ADHD controls. Method: We divided the participants, aged 17 to 40 years, into three groups—(a) ADHD, onset <7 years (early-onset, n = 142); (b) ADHD, onset between 7 and <12 years (late-onset, n = 41); (c) non-ADHD controls ( n = 148)—and compared their neuropsychological functioning, measured by the Cambridge Neuropsychological Testing Automated Battery. Results: Both ADHD groups had deficits in attention and signal detectability, spatial working memory, and short-term spatial memory, but only the early-onset group showed deficits in alertness, set-shifting, and planning after controlling for age, sex, and psychiatric comorbidities. There was no statistical difference between the two ADHD groups in neuropsychological functioning. Conclusion: DSM-5 criteria for diagnosing adult ADHD are not too lax regarding neuropsychological functioning.

scholarly journals Clozapine-Induced Microseizures, Orofacial Dyskinesia, and Speech Dysfluency in an Adolescent with Treatment Resistant Early Onset Schizophrenia on Concurrent Lithium Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Vivekananda Rachamallu ◽  
Ayman Haq ◽  
Michael M. Song ◽  
Manish Aligeti
Keyword(s):  
Tardive Dyskinesia ◽  
Early Onset ◽  
Peer Group ◽  
Case Reports ◽  
Multidisciplinary Treatment ◽  
Lithium Therapy ◽  
Adolescent Male ◽  
Seizure Threshold ◽  
Early Onset Schizophrenia ◽  
Orofacial Dyskinesia

Clozapine is an atypical antipsychotic used in the treatment of refractory schizophrenia. It has a well-known side effect profile, including agranulocytosis, decreased seizure threshold, and tardive dyskinesia. In addition, numerous case reports have described clozapine-induced stuttering in adults. However, there has been only one previous case report describing it in the adolescent population. In addition, concurrent lithium therapy has been shown to enhance the neurotoxic effects of antipsychotics and lower the seizure threshold. Here, we report on the development of clozapine-induced microseizures, orofacial dyskinesia, and stuttering in a 17-year-old adolescent male with treatment of refractory early onset schizophrenia on clozapine and concurrent lithium therapy. The patient’s symptoms of schizophrenia responded well to the clozapine regimen. However, with the escalating dose of clozapine, the patient developed speech dysfluency in the form of stuttering and perioral twitching. An electroencephalogram confirmed seizure activity. Due to similarities with tardive dyskinesia, symptoms of microseizures induced by atypical antipsychotics may not be accurately diagnosed. A multidisciplinary treatment of speech dysfluency is of particular importance in the adolescent schizophrenic patients, who are expected to have longer duration of lifetime exposure to antipsychotics and in whom peer group interaction is crucial for normal personal and social development.

Sustained attention deficit in bipolar disorder

2002 ◽  
Vol 180 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Luke Clark ◽  
Susan D. Iversen ◽  
Guy M. Goodwin
Keyword(s):  
Bipolar Disorder ◽  
Sustained Attention ◽  
Attention Deficit ◽  
Verbal Memory ◽  
Neuropsychological Functioning ◽  
Attentional Set ◽  
Illness Onset ◽  
Affective Symptoms ◽  
Attentional Set Shifting ◽  
Neuropsychological Tasks

BackgroundRecovery in bipolar disorder is central to its definition but is rarely complete. Previous work has suggested that neuropsychological impairment persists during the euthymic state but has been confounded partly by mild affective symptoms in remitted patients.AimsTo characterise neuropsychological functioning in the euthymic phase of bipolar disorder with an emphasis on tasks of executive functioning.MethodThirty euthymic patients with bipolar disorder were compared with thirty healthy controls on neuropsychological tasks differentially sensitive to damage within prefrontal cortex.ResultsBipolar I patients were impaired on tasks of attentional set shifting, verbal memory and sustained attention. Only sustained attention deficit survived controlling for mild affective symptoms. This deficit was related to progression of illness, but was none the less present in a subgroup of patients near illness onset.ConclusionsSustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved.

Time to Initiation of Clozapine Treatment in Children and Adolescents with Early-Onset Schizophrenia

2016 ◽  
Vol 49 (06) ◽  
pp. 254-259 ◽  
Author(s):  
E. Trinczek ◽  
M. Heinzel-Gutenbrunner ◽  
M. Haberhausen ◽  
C. Bachmann
Keyword(s):  
Children And Adolescents ◽  
Early Onset ◽  
Poor Prognosis ◽  
Psychiatric Hospitalization ◽  
Tertiary Care ◽  
Antipsychotic Treatment ◽  
Early Onset Schizophrenia ◽  
Clozapine Treatment ◽  
Time To Initiation ◽  
Clinical Records

Abstract Introduction: Early-onset schizophrenia (EOS) has a poor prognosis and is difficult to treat, which often leads to the initiation of clozapine treatment. Studies in adults have shown that the initiation of clozapine treatment is often delayed. There is a lack of studies concerning the initiation of clozapine in children and adolescents with EOS. The aim of this study was to investigate the time span from first EOS-related psychiatric hospitalization to clozapine initiation. Methods: We retrospectively studied a consecutive cohort of children and adolescents with EOS and first-time clozapine prescriptions from a tertiary care child and adolescent psychiatric center in Germany. Results: Clinical records with data on clozapine initiation were available for 112 patients (35.7% females, mean age: 15.2±1.6 years). The mean time from first EOS-related hospitalization to clozapine initiation was 1.1 (±1.0) years, with an average of 2.3 (±1.1) prior antipsychotic treatment episodes. Higher age and higher IQ predicted earlier clozapine initiation. At the time of clozapine initiation, 40.2% of patients received antipsychotic polypharmacy. Prior to clozapine, 33.9% of patients had received 3 or more antipsychotic treatment episodes. Discussion: In our study, clozapine treatment was initiated markedly earlier than in the few existing studies, which may partly be due to the expected poor prognosis of EOS. The significant portion of patients undergoing 3 or more antipsychotic trials or antipsychotic polypharmacy prior to clozapine may indicate a need for improved dissemination of knowledge on the effectiveness of clozapine in treatment-resistant schizophrenia in order to promote timely clozapine prescriptions in these cases.

Auditorisches Training auch bei früher Schizophrenie-Erkrankung wirksam

2020 ◽  
Vol 88 (08) ◽  
pp. 488-489
Keyword(s):  
Early Onset ◽  
Adult Onset ◽  
Early Onset Schizophrenia

Die wenigen Studien zum kognitiven Training bei Patienten mit früh beginnender Schizophrenie (Early-Onset-Schizophrenia, EOS) zeigten einen geringeren Behandlungserfolg als das kognitive Training bei Patienten, die als Erwachsene erkrankt sind (Adult-Onset-Schizophrenia, AOS). Eine Sekundäranalyse zweier Studien prüfte jetzt, ob ein auditorisches Training (AT) bei beiden Patientengruppen unterschiedlich wirksam ist.

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