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Collection of developmental history in the evaluation of schizophrenia spectrum disorders.

ABSTRACT: BACKGROUND:Schizophrenia is a heterogeneous disorder that is characterized by varying levels of hallucinations, delusions, negative symptoms, and disorganized features. The presence and severity of neurodevelopmental precursors and premorbid psychopathology also vary among individuals. To fully understand individual patients and to sort out phenotypic heterogeneity for genetic research studies, instruments designed to collect developmental history relevant to schizophrenia may be helpful. OBJECTIVE:The goal was to describe a pair of self-report and parent-report instruments developed for the purpose of collecting the developmental history of patients with known or suspected schizophrenia spectrum disorders. METHOD:Two developmental history instruments were designed for use in studies of brain morphology and cognition in schizophrenia probands and their unaffected siblings. The instruments focus mainly on motor abnormalities and other features that have been described as schizophrenia precursors. RESULTS:The Motor Skills History Form is a brief self-report form that asks about patients' childhood and adolescent motor abilities as well as their current motor functioning. The Developmental & Motor History Form is a more detailed parent-rated form that covers aspects of patients' early (infant/preschool) development; their childhood and adolescent motor abilities; any childhood behaviors that may be related to later psychosis risk; and their history of any neurological, emotional, or cognitive disorders diagnosed during childhood or adolescence. The instruments can be used either for interviews or as self-administered questionnaires. The parent-rated form has been used for research and for the clinical assessment of children and adolescents with complex neurodevelopmental presentations with or without strong evidence of schizophrenia risk. CONCLUSIONS:The collection of developmental history information is important when evaluating individuals with schizophrenia and related disorders. The Motor Skills History Form and the Developmental & Motor History Form can be used to collect this information for clinical evaluation or research purposes.

SUBMITTER: Reiersen AM

PROVIDER: S-EPMC4902265 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Collection of developmental history in the evaluation of schizophrenia spectrum disorders.

Reiersen Angela M AM

Scandinavian journal of child and adolescent psychiatry and psychology 20160101 1

<h4>Background</h4>Schizophrenia is a heterogeneous disorder that is characterized by varying levels of hallucinations, delusions, negative symptoms, and disorganized features. The presence and severity of neurodevelopmental precursors and premorbid psychopathology also vary among individuals. To fully understand individual patients and to sort out phenotypic heterogeneity for genetic research studies, instruments designed to collect developmental history relevant to schizophrenia may be helpful ...[more]

PMID: 27294074

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Project description:ImportanceAn assumption among clinicians and researchers is that patients with schizophrenia vary considerably in their response to antipsychotic drugs in randomized clinical trials (RCTs).ObjectiveTo evaluate the overall variation in individual treatment response from random variation by comparing the variability between treatment and control groups.Data sourcesCochrane Schizophrenia, MEDLINE/PubMed, Embase, PsycINFO, Cochrane CENTRAL, BIOSIS Previews, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform from January 1, 1955, to December 31, 2016.Study selectionDouble-blind, placebo-controlled, RCTs of adults with a diagnosis of schizophrenia spectrum disorders and prescription for licensed antipsychotic drugs.Data extraction and synthesisMeans and SDs of the Positive and Negative Syndrome Scale pretreatment and posttreatment outcome difference scores were extracted. Data quality and validity were ensured by following the PRISMA guidelines.Main outcomes and measuresThe outcome measure was the overall variability ratio of treatment to control in a meta-analysis across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model. A personal element of response was hypothesized to be reflected by a substantial overall increase in variability in the treatment group compared with the control group.ResultsAn RCT was simulated, comprising 30 patients with schizophrenia randomized to either the treatment or the control group. The different components of variation in RCTs were illustrated with simulated data. In addition, we assessed the variability ratio in 52 RCTs involving 15 360 patients with a schizophrenia or schizoaffective diagnosis. The variability was slightly lower in the treatment compared with the control group (variability ratio = 0.97; 95% CI, 0.95-0.99; P = .01).Conclusions and relevanceIn this study, no evidence was found in RCTs that antipsychotic drugs increased the outcome variance, suggesting no personal element of response to treatment but instead indicating that the variance was slightly lower in the treatment group than in the control group; although the study cannot rule out that subsets of patients respond differently to treatment, it suggests that the average treatment effect is a reasonable assumption for the individual patient.

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Collection of developmental history in the evaluation of schizophrenia spectrum disorders.

Publications

Collection of developmental history in the evaluation of schizophrenia spectrum disorders.

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