Duygu KABA, Pinar URAN, Ayla SOYKAN AYSEV

Co-Occurrence of Autism Spectrum Disorder and Very Early Onset Schizophrenia: a Case Report

Otizm yelpazesi bozukluğu ve çok erken başlangıçlı şizofreni birlikteliği: Bir olgu sunumu Çok erken başlangıçlı şizofreni (ÇEBŞ), kronik seyreden ve bireyi zayıf düşüren bir psikiyatrik bozukluk olup, literatürde yeterince ilgi görememiştir. Önceki çalışmalar ÇEBŞ'nin gidiş ve sonucunun erişkin başlangıçlı şizofreniden daha kötü yönde eğilim gösterdiğini ileri sürmüştür. Otizm yelpazesi bozukluğu (OYB), psikolojik gelişimin birçok alanında ciddi ve yaygın bozulmalarla karakterize yaşam boyu süren heterojen bir bozukluktur. Literatürde OYB ve ÇEBŞ komorbiditesi oldukça nadir olarak görülmektedir. Bu yazıda ÇEBŞ komorbiditesi olan bir OYB tanılı çocuk sunulmuştur. Bu vaka ile literatür ışığında, OYB ve ÇEBŞ'nin; ayırıcı tanısının yapılması, ortak ve farklı klinik özelliklerinin, beyin görüntüleme çalışmaları sonuçlarının ve genetik, çevresel etmenlerinin gözden geçirilmesi amaçlanmıştır.

Otizm yelpazesi bozukluğu ve çok erken başlangıçlı şizofreni birlikteliği: Bir olgu sunumu

Co-occurrence of autism spectrum disorder and very early onset schizophrenia: a case report Very early onset schizophrenia (VEOS) is a chronic and debilitating psychiatric disorder and has received too little attention in the medical literature. Previous studies have suggested that VEOS had a tendency of a worse prognosis and outcome than adult onset schizophrenia. Autism spectrum disorder (ASD) is a life-long impairing heterogeneous disorder, characterized by severe and pervasive impairments in multiple areas of psychological development. Co-occurrence of ASD and VEOS is reported very rarely in the literature. This paper reports on a case diagnosed as ASD with a VEOS comorbidity. With this case report, it is aimed to review the differential diagnosis, common and different clinical features, neuroimaging findings and genetic and environmental etiologies of these two psychopathologies in the light of the literature

PDF

___

1. Ozsungur B, Akdemir D, Cengel-Kultur E, Zeki A, Sinir H. Clinical presentation and diagnostic challenges in very early onset schizophrenia: case reports. Turkish Journal of Child and Adolescent Mental Health 2012; 19:87-95. (Turkish)
2. Kumra S, Charles Schulz S. Editorial: research progress in early-onset schizophrenia. Schizophr Bull 2008; 34:15-17. [CrossRef]
3. Hellgren L, Gilberg C, Enerskog I. Antecedents of adolescent psychoses: a population based study of school health problems in children who develop psychosis in adolescence. J Am Acad Child Adolesc Psychiatry 1987; 26:351-355. [CrossRef]
4. Rapoport J, Chavez A, Greenstein D, Addington A, Gogtay N. Autism spectrum disorders and childhood-onset schizophrenia: clinical and biological contributions to a relation revisited. J Am Acad Child Adolesc Psychiatry 2009; 48:10-18. [CrossRef]
5. Cochran DM, Dvir Y, Frazier JA. “Autism-plus” spectrum disorders: intersection with psychosis and the schizophrenia spectrum. Child Adolesc Psychiatr Clin N Am 2013; 22:609-627. [CrossRef]
6. Sebat J, Levy DL, McCarthy SE. Rare structural variants in schizophrenia: one disorder, multiple mutations; one mutation, multiple disorders. Trends Genet 2009; 25:528-535. [CrossRef]
7. Chubb JE, Bradshaw NJ, Soares DC, Porteous DJ, Millar JK. The DISC locus in psychiatric illness. Mol Psychiatry 2008; 13:36-64. [CrossRef]
8. Wang HG, Jeffries JJ, Wang TF. Genetic and developmental perspective of language abnormality in autism and schizophrenia: one disease occurring at different ages in humans? Neuroscientist 2015; 22:119-131. [CrossRef]
9. Gardener H, Spiegelman D, Buka SL. Prenatal risk factors for autism: comprehensive meta-analysis. Br J Psychiatry 2009; 195:7-14. [CrossRef]
10. Cheung C, Yu K, Fung G, Leung M, Wong C, Li Q, Sham P, Chua S, McAlonan G. Autistic disorders and schizophrenia: related or remote? An anatomical likelihood estimation. PLoS One 2010; 5:e12233. [CrossRef]
11. Shenton ME, Dickey CC, Frumin M, McCarley RW. A review of MRI findings in schizophrenia. Schizophr Res 2001; 49:1-52. [CrossRef]
12. Hwang MY, Hollander E. Schizo-obsessive disorders. Psychiatr Ann 1993; 23:396-401. [CrossRef]
13. Buckeley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities and schizophrenia. Schizophr Bull 2009; 35:383- 402. [CrossRef]
14. Berman I, Kalinowski A, Berman SM, Lengua J, Green AI. Obsessive and compulsive symtoms in chronic schizophrenia. Compr Psychiatry 1995; 36:6-10. [CrossRef]
15. Faragian S, Fuchs C, Pashinian A, Weizman R, Weizman A, Poyurovsky M. Age-of-onset of schizophrenic and obsessivecompulsive symptoms in patients with schizo-obsessive disorder. Psychiatry Res 2012; 197:19-22. [CrossRef]
16. Crespi BJ, Thiselton DL. Comparative immunogenetics of autism and schizophrenia. Genes Brain Behav 2011; 10:689-701. [CrossRef]
17. Gaebel W, Riesbeck M, Janssen B, Schneider F, Held T, Mecklenburg H, Sass H. Atypical and typical neuroleptics in acute schizophrenia and related delusional disorders. Drug choice, switching and outcome under naturalistic treatment conditions. Eur Arch Psychiatry Clin Neurosci 2003; 253:175- 184. [CrossRef]
18. Voruganti L, Cortese L, Oyewumi L, Cernovsky Z, Zirul S, Awad A. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability side-effect profile and impact on quality of life. Schizophr Res 2000; 43:135-145. [CrossRef]
19. Rabinowitz J, Lichtenberg P, Kaplan Z. Comparison of cost, dosage and clinical preference for risperidone and olanzapine. Schizophr Res 2000; 46:91-96. [CrossRef]