Developmental Coordination Disorder Plus Oculomotor and Visuospatial Impairment as Neurodevelopmental Heralds of Psychosis Proneness.

Q4 Medicine
Michele Poletti, Eva Gebhardt, Andrea Raballo
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引用次数: 0

Abstract

Aiming at preventing transitions to more severe psychopathology and boosted by the availability of operational criteria to identify help-seeking subjects at increased risk for psychosis, research into the early prodromal phases of psychosis is attracting a growing clinical interest. Furthermore, the focus of early detection is gradually shifting from prodromal syndromes to the premorbid period. Although mainly driven by clinical-pragatic aims, such a shift is coherent with the neurodevelopmental hypothesis of schizophrenia that might offer a unifying, developmentally informed conceptual framework for early detection. Psychotic experiences, indeed, while overtly manifested in adolescence/early-adulthood, are often antedated by subtle expressions of biological vulnerability already presenting in the early years of life and indexing a putatively altered neurodevelopmental process. Concretely, unspecific premorbid symptoms that may be present since infancy and childhood may lead to early clinical consultancy in child-adolescent mental health services, which could be considered the primary clinical setting to implement early detection. We herewith present a clinical vignette of a child with severe Developmental Coordination Disorder presenting an Attenuated Psychosis Syndrome. The vignette illustrates the intertwining between possible early neurodevelopmental disorders and clinical psychosis proneness in childhood.

发育协调障碍加上眼球运动和视觉空间障碍是精神病易感性的神经发育先兆。
为了防止患者过渡到更严重的精神病态,并通过可操作的标准来识别精神病风险增加的求助对象,对精神病早期前驱阶段的研究正吸引着越来越多的临床兴趣。此外,早期检测的重点正逐渐从前驱综合征转移到发病前期。虽然这种转变主要是出于临床箴言的目的,但它与精神分裂症的神经发育假说是一致的,后者可能会为早期检测提供一个统一的、以发育为基础的概念框架。事实上,精神错乱的经历虽然在青春期/成年早期有明显的表现,但往往是在生命早期就已经出现的生物脆弱性的微妙表现,并表明神经发育过程可能发生了改变。具体来说,自婴儿期和儿童期就可能出现的非特异性病前症状可能会导致儿童青少年心理健康服务机构的早期临床咨询,而儿童青少年心理健康服务机构可被视为实施早期检测的主要临床环境。我们在此介绍一名患有严重发育协调障碍并伴有减弱性精神病综合征的儿童的临床案例。该案例说明了儿童期可能存在的早期神经发育障碍与临床精神病易感性之间的相互联系。
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来源期刊
Clinical Schizophrenia and Related Psychoses
Clinical Schizophrenia and Related Psychoses Medicine-Psychiatry and Mental Health
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期刊介绍: The vision of the exciting new peer-reviewed quarterly publication Clinical Schizophrenia & Related Psychoses (CS) is to provide psychiatrists and other healthcare professionals with the latest research and advances in the diagnosis and treatment of schizophrenia and related psychoses. CS is a practice-oriented publication focused exclusively on the newest research findings, guidelines, treatment protocols, and clinical trials relevant to patient care.
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