Wayne H. Green

Schizophrenia with Childhood Onset: A Phenomenological Study of 38 Cases

Thirty-eight hospitalized children, ages 5.7 to 11.11 years, diagnosed with schizophrenic disorder by DSM-III criteria, are characterized regarding age, sex, race, socioeconomic status, pre- and perinatal complications, electroencephalogram, intelligence quotient, and family history of major psychiatric disorder. Clinical course, including age at onset of general and psychotic psychiatric symptoms and initial diagnosis of schizophrenic disorder, presence of DSM-III symptoms, hospital course, and response to antipsychotics are reviewed.

A Comparison of Schizophrenic and Autistic Children

A comparison of schizophrenic, autistic, and conduct disordered children ages 5.2 to 12.10 years is presented. Diagnosis was made by the authors in all cases using DSM-III criteria. The children were compared on a variety of variables including pre- and perinatal complications, intellectual functioning, and behavioral profile. Findings indicate that children under 12 years of age can be diagnosed schizophrenic disorder by DSM-III criteria. All schizophrenic children had a disorder of thinking and most had hallucinations (83.3%) while delusions were somewhat less frequent (54.2%). Schizophrenic children differ from autistic children on most variables although there is some overlap.

The Effects of Haloperidol on Learning and Behavior in Autistic Children.

The effects of haloperidol on behavioral symptoms and learning were critically assessed in autistic children in an ongoing double-blind placebo-controlled clinical trial. Children were randomly assigned to haloperidol-placebo-haloperidol or placebo-haloperidol-placebo treatment sequences. Statistically, haloperidol was significantly superior to placebo in reducing behavioral symptoms. In discrimination learning paradigm, children receiving haloperidol learned the discrimination while those on placebo did not. Discrimination attained on haloperidol was retained when the children were switched to placebo.

Psychosocial dwarfism: a critical review of the evidence

Diagnostic criteria for classical psychosocial dwarfism (PSD) are given and behavioral, environmental and endocrinologic findings are reviewed. It is concluded that PSD does occur independently of malnutrition. However, the growth retardation and catch-up growth upon removal from the inimical environment do not correspond directly to any consistent endocrine finding. A new hypothetical model is presented to clarify relationships among environments, hormonal levels and growth.

Some physical parameters of young autistic children.

Abstract This paper provides information relevant to growth and development in a sample (N = 101) of young autistic children. Though birth weights of patients did not deviate from normative findings or from those of their own siblings, the distribution of heights between ages 2 and 7 years was significantly different from the normal population. Certain additional measures were available in a subgroup of patients: severity of illness and blood lead levels were negatively correlated with language DQ and IQ levels. A significant number had elevated T 3 and T 4 levels, and the latter were positively correlated with minor physical anomaly scores. These results are discussed as they relate to the concepts of biological age and hypothalamic dysfunction.

Use of lithium in children and adolescents

Abstract The evidence for lithiums efficacy in psychiatric disorders of children and adolescents is surveyed, with discussion of the results of short- and long-term maintenance treatment and side effects. Because most reports are not well-documented and/or have methodologic flaws, at present, clear recommendations for use of lithium in this population cannot be given. However, there is some suggestion that behavioral symptoms, particularly aggressiveness, if accompanied by a strong affective-explosive component, decrease with lithium administration.

Blood Platelet Monoamine Oxidase Activity in Schizophrenic Children and Their Families

In this study monoamine oxidase (MAO) activity was measured in blood platelets of 21 individuals (age 2 6/12-19 years) who were diagnosed at preschool age as schizophrenics; MAO activity was not significantly different from that found in normals. An insignificant correlation was found between MAO activity in patients and age; a similar correlation for normals was also insignificant. In a sample of 15 families, no significant correlation between MAO activity of patients and their parents was obtained.

Overview of Drug Treatment in Autism

Infantile autism is a pervasive developmental disorder characterized by a failure to develop relatedness, language abnormalities, and cognitive lags and deficits of various degrees. Mental subnormality is an important aspect in the majority of autistic children. The goals of treatment are twofold: first, to decrease the behavioral symptoms and, second, to promote development and to foster skills that are absent or only rudimentary.

Plasma growth hormone response to oral l-dopa in infantile autism.

In order to assess further the occurrence of hypothalamic dysfunction in infantile autism and its possible relationship to dopaminergic abnormalities, the 1-dopa provocative test was performed in 22 patients fulfilling DSM-III criteria for this disorder. The results indicate a high incidence (at least 30%) of blunted plasma growth hormone (GH) responses following oral administration of 1-dopa in this sample. These data suggest an alteration of hypothalamic dopamine receptor sensitivity in the patients with blunted responses. Thus, a subgroup of autistic patients within a descriptively homogeneous diagnostic category shows evidence of hypothalamic dysregulation and dopaminergic abnormalities.

Effects of lithium carbonate and haloperidol on cognition in aggressive hospitalized school-age children.

A comparison of the effects of lithium, haloperidol, and placebo on cognition is reported for a sample of hospitalized school-age children with a behavioral profile of aggressiveness and explosiveness. In this double-blind study, patients were randomly assigned to one of three treatment conditions. The cognitive battery was administered at the end of a 2-week placebo baseline period and again after 4 weeks of treatment. It included a simple reaction time (RT) task with preparatory intervals of 1, 4, and 8 seconds, the Porteus Mazes, and the Matching Familiar Figures Test. Drug effects on cognition, when found, were mild. Slower and more variable RTs were found on the RT task in the haloperidol group (mean dose, 3.1 mg/day), particularly at the 4- and 8-second preparatory intervals in comparison to placebo. This appeared to reflect decreased ability to hold a preparatory set. No other effects of haloperidol on cognitive performance were found. Lithium carbonate (mean dose, 1150 mg/day) caused a deterioration in qualitative performance on the Porteus Maze Test when compared with haloperidol but had no effect on test quotient scores or on the other cognitive measures. Results are discussed in terms of dose effects and the influences of task demands. This is part of a study critically assessing the effects of lithium and haloperidol on behavioral symptoms and other parameters.