Journal
JOURNAL OF PSYCHIATRIC RESEARCH
Volume 47, Issue 8, Pages 1061-1068Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychires.2013.03.013
Keywords
Child Behavior Checklist (CBCL); Antecedents; Risk factors; Psychosis; Developmental psychopathology
Categories
Funding
- Schizophrenia Research Institute from the NSW Ministry of Health
- National Institute for Health Research (NIHR) [CDF/08/01/015]
- Bial Foundation [35/06]
- NARSAD
- British Medical Association
- NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust
- Institute of Psychiatry, King's College London, United Kingdom
- National Institute for Health Research [CDF/01/015] Funding Source: researchfish
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Social withdrawal is a robust childhood risk factor for later schizophrenia. The aims of this paper were to assess the evidence for childhood social withdrawal among adults with schizophrenia and, comparatively, in children aged 9-14 years who are putatively at-risk of developing schizophrenia. We conducted a meta-analysis, including cohort and case-control studies reporting social withdrawal measured by the Child Behavior Checklist (CBCL) in adults with schizophrenia vs. controls. Further, an experimental study compared CBCL withdrawal scores from typically-developing children with scores from two groups of putatively at-risk children: (i) children displaying a triad of replicated antecedents for schizophrenia, and (ii) children with at least one first- or second-degree relative with schizophrenia or schizoaffective disorder. Six studies met inclusion criteria for the meta-analysis (N = 3828), which demonstrated a large effect of increased childhood social withdrawal in adults with schizophrenia (standardized mean difference [SMD] score = 1.035, 95% CI = 0304-1.766, p = 0.006), with no indication of publication bias, but considerable heterogeneity (I-2 = 91%). Results from the experimental study also indicated a large effect of increased social withdrawal in children displaying the antecedent triad (SMD = 0.743, p = 0.001), and a weaker effect in children with a family history of schizophrenia (SMD = 0.442, p = 0.051). Childhood social withdrawal may constitute a vulnerability marker for schizophrenia in the presence of other antecedents and/or genetic risk factors for schizophrenia. (C) 2013 Elsevier Ltd. All rights reserved.
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