Saturday, January 23, 2010

Predicting schizophrenia

One neat thing about science is that when somebody does a study and publishes the data, other people can parse the data in different ways and find out stuff the original researchers weren't thinking of. Some researchers from Duke have looked at a long-term study of 1000 people born in New Zealand in 1972 and 1973 and found that the 1%  to 3.5% of people who developed schizophrenia as adults showed a consistent pattern of cognitive difficulties starting at about age 7.
For each year between the ages of 7 and 13, the children who later received a diagnosis of schizophrenia lost between 0.17 and 0.26 years in mental age when compared with the other children.
Two patterns emerged: The children who developed adult schizophrenia had early deficits in verbal and visual learning, reasoning and conceptualization that remained with them as they grew. They also showed slower development than their peers in processing speed, attention, visual-spatial problem-solving and working memory. The data argues against one theory that schizophrenia stems from a deterioration of cognitive abilities. The minds of these children grew, they just didn't grow as well.
 We're back to the question of what do you do with a kid if you know she has a good chance of developing some mental problem later?

One complication here is that something like 20% of kids had similar cognitive problems but did not become schizophrenic. So suppose a 7 or 8 year old shows the problems. If all this is true, you know she has about a 5% chance of becoming schizophrenic. Or let's make it harder. You have a class of 20 kids with cognitive problems. Odds are one of them will turn out to have been in an early stage of schizophrenia.

What do you do? Nothing directly. You certainly couldn't give anti-psychotic drugs to all 20. I haven't particularly looked into it, but I'm not aware of any cognitive therapies for schizophrenia, and in any case you wouldn't want to do that to the other 19 kids, either. I guess all you can do is watch for clearer signs and then start the meds. Sometimes knowing just a little too much is depressing.

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