Developmental trajectories and psychopathology in young relatives at risk for schizophrenia

Presentation First Author: 
Matcheri S Keshavan

Objectives. A great deal of research has focused on identifying predictors and developing early interventions for individuals with psychotic disorders such as schizophrenia. While the relationships between early psychopathology, neurocognitive and social deficits and later emergence of psychosis have been studied for some time, the temporal evolution of psychopathology and its neurodevelopmental parallels in individuals at high risk (HR) for schizophrenia is less well characterized. Method.Using age-appropriate structured diagnostic interviews and consensus diagnostic evaluations, we prospectively examined the ages of onset of axis-I psychiatric disorders in 169 adolescents and young adults (mean ~15.9) at high familial risk for schizophrenia or schizoaffective disorder. Psychopathological, neurocognitive and neuroimaging assessments were carried out annually in a subset of these individuals and a group of age and sex matched healthy controls (HC) up to 3 years.Results About 60% of HR subjects had one or other axis I psychopathology as evaluated longitudinally. Attention deficit/ Conduct/Learning disorders had the earliest ages of onset, followed by Affective and Anxiety disorders and Substance use disorders. Sub-threshold (prodromal) syndromes and schizophrenia or related psychoses appeared latest, (initially Intermittent and later Chronic). The neurocognitive and neurobiological correlates of this psychopathological trajectory will be presented.Discussion.We propose that the premorbid and prodromal phases of schizophrenia in at-risk relatives may be characterized by A_CLAASSic trajectory of psychopathology emerging from childhood to young adulthood. Understanding such patterns of psychopathological evolution and their dynamic neurodevelopmental underpinnings could be of considerable importance for early detection and intervention efforts.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Jai L Shah - Neeraj Tandon - Debra M Montrose
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