Clozapine augmented with amisulpride in 3 cases of treatment-resistant early- and very early-onset schizophrenia

摘要

To the Editors: Schizophrenia in children is rare with a prevalence of approximately 0.1%. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA 2000) proposes the same diagnostic criteria regardless of age. A recent classification divides pediatric schizophrenia to early-onset (EOS), when the psychotic symptoms are present after the age of 13 years, and very early-onset (VEOS), when the onset is at or before the age of 13 years. Early-onset schizophrenia and VEOS show atypical features compared with adult-onset schizophrenia (AOS), such as insidious onset, more severe premorbid neurodevelopmental abnormalities, more frequent visual hallucinations, inappropriate or blunted affect, higher rate of familial psychopathology, reduced treatment response, and poorer outcome. Very early-onset schizophrenia and EOS may also have greater familial vulnerability.