Zeroing in on early cognitive development in schizophrenia

摘要

Thoughts about the role of development in schizophrenia have evolved in recent decades. Early formulations of the "neurodevelopmental hypothesis" suggested mechanisms whereby "probably congenital and static" neurophysiological insults might remain for the most part silent, behaviorally, until the onset of schizophrenia in late adolescence or early adulthood (1). Recent versions reflect a more dynamic view of the densely interacting effects of biology and environment on behavior over the course of development (2). They also emphasize the now extensive evidence that some children who will later have schizophrenia show marked abnormalities in motor, cognitive, emotional, and social development years before the onset of psychotic symptoms (3). Among these developmental manifestations, an increasing lag in intellectual development during childhood may show some specificity in prediction of later psychosis (4), while motor, emotional, and social problems seem to be nonspecific risk factors for a variety of adult neuropsychiatric outcomes (3).