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Review
. 2016 Apr;51(4):475-91.
doi: 10.1007/s00127-015-1151-x. Epub 2015 Dec 15.

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Kristin R Laurens  1   2   3 , Alexis E Cullen  4   5
Affiliations
Review

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

Kristin R Laurens et al. Soc Psychiatry Psychiatr Epidemiol. 2016 Apr.

Abstract

Purpose: The London Child Health and Development Study (CHADS) is a prospective, longitudinal investigation of children, sampled from the general community aged 9-11 years and assessed biennially, who present premorbid risk markers for schizophrenia. The study aims to characterise developmental trajectories of psychological, cognitive, and biological functioning in at-risk children and identify potential targets for early preventative intervention. This review summarises CHADS findings, discusses these in the context of recent theory regarding aetiology and prevention of schizophrenia, and highlights challenges to be addressed with future research.

Methods: We review (1) epidemiological information on the prevalence and correlates of developmental antecedents of schizophrenia in the general child population, (2) evidence of psychosocial, cognitive, and biological dysfunctions in at-risk children presenting multiple antecedents of schizophrenia and at-risk children with a family history of schizophrenia, and (3) related findings from an associated sample of help-seeking children receiving intervention.

Results: Community-based screening of 9-11-year olds identified ~9 % with a triad of antecedents of schizophrenia [including psychotic-like experiences (PLEs)] who are putatively at-risk of psychosis; these children reported greater exposure and responsivity to stressors, impairments in general intelligence and specific cognitive functions, brain structure and function abnormalities, and neuromotor dysfunction. Preliminary evidence suggests distressing PLEs are a viable target for cognitive-behavioural intervention in at-risk children.

Conclusions: Intervention in early, premorbid phases of illness might alleviate current difficulties and avert future schizophrenia using benign treatments. The CHADS programme has identified several markers that may index early pathophysiology and constitute potential targets for preventative intervention.

Keywords: Adolescence; Developmental psychopathology; High-risk; Psychosis; Psychotic-like experiences.

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Figures

Fig. 1
Fig. 1
Venn diagram indicating the percentages of children displaying antecedents within each domain of the triad (overlapping segments indicate children who displayed multiple antecedents); based on data from 1504 child–caregiver dyads who completed screening questionnaires
See this image and copyright information in PMC

Comment in

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