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Accumulating evidence suggests that early-onset schizophrenia arises from a disturbance in the normal trajectory of cerebral development.
To investigate brain structure, asymmetry and IQ in early-onset schizophrenia.
Volumes of left and right cerebral hemispheres and IQ were assessed in 33 participants with early-onset DSM – IV schizophrenia and 30 members of a matched, normal control group.
Total brain volume was significantly smaller in the group with early-onset disease (‘cases’) relative to the control group (4.5%), especially for the left hemisphere in males (6.0%). A significant sex x diagnosis interaction in hemisphere asymmetry revealed that the female cases group had significantly reduced rightward asymmetry relative to the female control group and that the male cases tended to have reduced leftward asymmetry relative to the male control group. Decreased left hemisphere volume in males and decreased rightward hemispheric asymmetry in females correlated with reduced IQ.
Sexually dimorphic alterations in asymmetry correlate with degree of intellectual impairment in early-onset schizophrenia.
Subtle formal thought disorders are difficult to quantify. Their relationship to florid thought disorder is unknown.
To assess the interrater reliability, sensitivity and factor structure of a new assessment instrument, the Thought and Language Index (TLI), and to determine if minor aberrations detectable in the speech of healthy individuals are related to the more severe formal thought disorders characteristic of schizophrenia.
Interrater reliability was evaluated by determining the intraclass correlation for the ratings by five assessors. Factor analysis of the TLI scores of 87 patients was performed, and TLI scores in matched patients and controls were compared.
The intraclass correlation was good for individual TLI items, and excellent for sub-scale scores. Factor analysis identified three groups of approximately orthogonal disorders. Mild speech aberrations were observed in healthy participants and in patients with schizophrenia. The prevalence of mild aberrations was correlated with the prevalence of definite formal thought disorders.
The TLI is reliable and capable of detecting subtle disorders. Some mild aberrations occurring in the speech of healthy individuals appear to be attenuated forms of the florid disorders characteristic of schizophrenia.
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