Childhood-Onset Schizophrenia

• DOI: 10.1001/archpsyc.63.7.721
• Publication Date: 2006-07-05T21:22:26Z
• Authors: Philip Shaw; Alex Sporn; Nitin Gogtay; Gerald P. Overman; Deanna Greenstein; Peter Gochman; Julia W. Tossell; Marge Lenane; Judith L. Rapoport
• Keywords: Clinical Global Impression

<h3>Background</h3> Childhood-onset schizophrenia is a rare but severe form of the disorder that frequently treatment resistant. The psychiatrist has limited evidence base to guide treatment, particularly as there are no trials in children comparing atypical antipsychotics, mainstay current treatment. <h3>Objective</h3> To compare efficacy and safety olanzapine clozapine, hypothesizing clozapine would be more efficacious. <h3>Design</h3> Double-blind randomized 8-week controlled trial, with 2-year open-label follow-up. <h3>Setting</h3> National Institute Mental Health study, January 1998 June 2005. Patients underwent reassessment 2 years after discharge. <h3>Patients</h3> Children adolescents recruited nationally, aged 7 16 years, meeting unmodified<i>DSM-IV</i>criteria for schizophrenia, resistant at least antipsychotics. <h3>Interventions</h3> After drug washout 1- 3-week antipsychotic-free period, patients were (n = 12) or 13). <h3>Main Outcome Measures</h3> Clinical Global Impression Severity Symptoms Scale Schedule Assessment Negative/Positive Symptoms. <h3>Results</h3> Clozapine was associated significant reduction all outcome measures, whereas showed less consistent profile clinical improvement. While moderate large differential effects favor these reached significance only alleviation negative symptoms from an baseline (<i>P</i> .04; effect size, 0.89). overall adverse events. At follow-up, 15 receiving sustained improvement, additional events emerged, including lipid anomalies 6) seizures 1). <h3>Conclusions</h3> not demonstrating definitively superiority compared treatment-refractory childhood-onset study suggests favorable response, which balanced against