January 17, 2006

New Book: Juvenile-Onset Schizophrenia

A new book has been published - that is written more for mental health professionals, but may be of interest to family members who are interested in learning more in-depth information about schizophrenia.

The book review, from the Canadian Journal of Psychiatrys, states:

Juvenile-Onset Schizophrenia: Assessment, Neurobiology and Treatment Robert L Findling, S Charles Schulz, editors. Baltimore (MD): Johns Hopkins University Press; 311 p. US$49.95.

The title of this book echoes the more familiar diagnosis of juvenile-onset diabetes and thus implies an illness different in cause and in course from one that begins in later adult years-an interesting speculation that is unfortunately not addressed in this book.

The first chapter discusses the phenomenology of adolescent-onset psychosis, which immediately introduces the core question: What is psychosis? As Gabrielle Carlson and others, the authors of Chapter 1, point out, the definition is "by no means fixed." It is generally acknowledged that a relation exists between the various definitions of psychosis and the illness schizophrenia, but psychosis occurs in many other illnesses, and schizophrenia, by definition a psychotic illness, can at times be diagnosed without the usual signs of psychosis (that is, delusions and hallucinations). Nonetheless, the authors conclude that, whatever the diagnosis, psychosis in adoelscence is preceded by poor cognitive functioning and childhood psychiatric symptoms that need attending to as much, if not more, than the psychosis—a clinically relevant recommendation.

Chapter 2 zeroes in on schizophrenia and attempts a unitary and integrative glutaminergic developmental hypothesis to account for the known facts about this elusive illness. From a clinical point of view, this suggests that drugs that reduce glutamate release, such as lamotrigine, would be useful for treating schizophrenia. Lamotrigine has proven highly successful in the treatment of mood disorder, which again brings up the questions raised in Chapter 1: What is included in the term psychosis? In what way is schizophrenia a stand-alone illness?

Chapter 3, by Tonya White and Charles Nelson, is an informative review of neurobiological development during childhood and adolescence. Logically, however, it should have come at the beginning of the book.

See this page for the full review: Juvenile-Onset Schizophrenia


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