November 1988

Neurodevelopmental Model of Schizophrenia

Author Affiliations

Adolescent Day Services Adolescent and Child Division Chestnut Lodge Hospital Rockville, MD 20850

Arch Gen Psychiatry. 1988;45(11):1051. doi:10.1001/archpsyc.1988.01800350085013

To the Editor. —  Weinberger's1 recent review is an impressive and thoughtprovoking attempt to give a neurodevelopmental account of various aspects of schizophrenia. His model of an early lesion that remains largely silent until it is "unmasked" by the neuromaturational changes of late adolescence is of particular relevance to work with high-risk offspring and preschizophrenic children. In childhood, even before the development of any pathognomonic signs of schizophrenia, many such individuals show attentional and information-processing deficits, neurologic soft signs, autonomic abnormalities, and nonspecific behavioral and personality problems.2However, Weinberger's model is difficult to reconcile with the phenomenon of childhood-onset schizophrenia. Although uncommon, there are many cases of prepubertal children, some as young as 5 years, who meet the full DSM-III3 criteria for schizophrenia, including delusions, hallucinations, and formal thought disorder.4 Controversy continues regarding the cause, genetics, and appropriate classification of this childhood-onset disorder as well as

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