A New Look at When Schizophrenia Starts

Raquel Gur, a University of Pennsylvania neuropsychiatrist and nationally known expert on schizophrenia, is at the forefront of the new way of thinking about the disorder, which affects 1 percent of the population.

Scientists now view it as a neurodevelopmental condition that begins years before its most disturbing symptoms appear, in much the same way that heart disease begins long before the first heart attack.

Gur’s painstaking work, done with the help of 9,500 Philadelphia children and their families, finds that those at risk for psychosis diverge from their peers in important ways as early as age 8. The differences in brain functioning —these are thinking skills, not psychosis —widen in the mid-teens.

The tantalizing question is whether early identification and treatment can delay or prevent the onset of psychosis, allowing young sufferers time to build a firmer foundation for life.

It’s early, but there is some evidence that the answer is yes.

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Several times over the last couple of years while doing research I have questioned/wondered why no one was looking at it as neurological.

Looking back-I never saw anything in my son that would indicate SZ. I do remember him having problems in school. He would finish his assignments quickly, and then start talking to other kids-which would get him in trouble.
The only thing that stands out in my mind, and it`s the same today, is that he does whatever he wants. The only thing he seems to pay attention to is an authority figure, or court systems, police, etc…I used to think he hated authority figures, but that is the only thing that stops him.
I still wonder if it was the car accident or the drugs that triggered everything…

Studying a predictor of schizophrenia sounds like a hugely daunting task. I wonder what the criteria they are using to decide the “placeholder diagnoses?” Out of all of the participants who received this diagnoses, only 30% developed psychosis. It sounds like this sample contained children who were already symptomatic too, since the article says that only 17% of those participants who were “normal” at intake later developed “sub-psychotic or psychotic symptoms.” “Placeholder diagnoses” just sounds like wishful thinking at this point, especially with so many false positives.