Clarice J. Kestenbaum

An emerging schizophrenic syndrome

This case history describes a 16-year-old adolescent male who developed schizophrenia with prominent negative symptoms. For the previous 6 years his diagnosis had been oppositional defiant disorder or conduct disorder. The clinical presentation, differential diagnosis, and management are discussed. The case exemplifies issues addressed in DSM IV.

Jerry Wiener, M.D. (1933–2002)

Journal of the American Academy of Child & Adolescent Psychiatry - Vol. 42 - N° 3 - p. 380-381

Childhood Schizophrenia: Theoretical and Treatment Issues

Michael is an 8.5-year-old Caucasian male inpatient who presented at admission with severe agitation, suicidal impulses, and aggression toward his 18-month-old sister. He had been treated with stimulant medications before admission. Past history revealed bilateral genetic loading with two primary family members having a history of hallucinations and hospitalization, and two paternal aunts who were hospitalized since early childhood. Michael was raised in a chaotic, violent family environment where there was emotional, physical, and perhaps sexual abuse. Medical history included frequent staring spells. During residential treatment, more extensive interviews revealed a years history of auditory hallucinations, inappropriate and labile affect, and a fixed delusional system. The patient was switched to neuroleptics and showed a slow response despite high doses.