Prediction of adult-onset schizophrenia from childhood home movies of the patients

Clinical symptoms of adult-onset schizophrenia are believed to begin between the ages of 20 and 25 years. But because research reveals that genetic factors and brain abnormalities are involved in schizophrenia, it makes sense that the pathology is at work at a much earlier age. Since data collected retrospectively have been shown to be inconsistent and unreliable, it is difficult to identify early developmental predictors of schizophrenia. Follow-back studies using school records and teachers' comments show that the first behavioral distinguishing point is adolescence, when pre-schizophrenic subjects have a greater incidence of behavioral problems. Schizophrenic subjects also showed significant deficits in test scores as far back as first grade. Using home movies to look for distinguishing factors between pre-schizophrenic children and their healthy siblings provides a unique opportunity. Home movies of five schizophrenic patients and their healthy siblings from birth to eight years of age were viewed by 13 graduate psychology students and six experienced clinicians. The viewers did not know the psychiatric status of any of the children, but were told that one child in each family later became schizophrenic. They were asked to identify which child they thought this was by using their own criteria, and to comment on which characteristics entered into their decisions. The viewers were also asked to rate their confidence in their judgment on a 4-point scale of no confidence to very confident. There was no significant relationship between accuracy and this confidence rating, or the experience of the viewer. In a preliminary study using the films of one of the schizophrenics and his siblings, five out of seven graduate psychology students correctly selected the patient, even though the parents had said that they had detected no signs of impending disorder until the patient was 22 years of age, and out of all their children he was the one they would have least expected to develop a problem. All the viewers had commented that they perceived this child to manifest abnormal emotional expressions and movements. All pre-schizophrenic children were identified at above-chance levels, and the viewers noted less responsiveness, eye contact, and positive expression, and poorer fine and gross motor coordination as identifying characteristics. It is suggested that these observable manifestations which helped make the correct selection may not be specific for schizophrenia, but may be signs of vulnerability that increase the risk for a variety of disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)