Schizophrenia childhood type and autism

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Sora
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14 Aug 2008, 1:37 pm

I have heard it before that autism just some 40+ years ago was categorised under early childhood schizophrenia. I want to find a good source that states so and shows how that diagnosis was used in the past (meaning, that autistic people were indeed diagnosed as having a type of schizophrenia).

But I have trouble finding anything on that other than the short definitions of schizophrenia childhood in the type early editions of the DSM. Such as this: http://unstrange.com/dsm1.html

Does anyone can explain a bit about it or point out links about this?


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anbuend
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14 Aug 2008, 1:39 pm

Good source?

You don't even need references. Just go to the old title of journal of autism and developmental disorders. It used to be, journal of autism and childhood schizophrenia. That says it all without you even having to read what's inside of it.


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Callista
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14 Aug 2008, 3:50 pm

Yes, but details... Like why they thought it was a kind of schizophrenia, and what they did to try to treat it, and who figured out it wasn't schizophrenia at all...


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ChristinaCSB
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14 Aug 2008, 4:22 pm

I heard some where that children can't actually have schizophrenia, which to me makes sense because children live in fantasy world, but if you are an adult and you stuck in fantasy it's schizphrenia....?



Zsazsa
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14 Aug 2008, 4:41 pm

I was one of those kids diagnosed with Childhood Schizophrenia at the age of twelve...before the Autism Spectrum Disorders
were recognized in 1994.

I never had hallucinations or delusions, never "heard voices," or anything that characterizes the "Schizophrenias". Psychiatrists and Psychologists had "no name" for the emotional difficulties I was experiencing as a kid...

but, for insurance purposes, and so the doctors could get paid, they gave my emotional difficulties a name they could think of
at the time...Childhood Schizophrenia and also, known as Atypical Childhood Psychosis.

Treatment? All the doctors did was load me up on psychiatric drugs as a kid... currently, as an adult, I am not on any of those toxic drugs. I am not certain I can totally repair my life from all the "damage" psychiatrists and the mental health system
has done.

All I realized since childhood is that there is no "care" in the mental health system.



LostInSpace
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14 Aug 2008, 4:44 pm

Here are some quotes from Kanner's original 1943 paper, "Autistic Disturbances of Affective Contact," in which he describes 11 kids who exhibit severe difficulties with social interaction and language:

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"It is quite possible that some such children have been viewed as feebleminded or schizophrenic. In fact, several children of our group were introduced to us as idiots or imbeciles, one still resides in a state school for the feebleminded, and two had been previously considered as schizophrenic.


Quote:
The combination of extreme autism. obsessiveness, stereotypy, and echolalia brings the total picture into relationship with some of the basic schizophrenic phenomena. Some of the children have indeed been diagnosed as of this type at one time or another. But in spite of the remarkable similarities, the condition differs in many respects from all other known instances of childhood schizophrenia.


He also describes the older sister of one of the kids in the case study, who sounds like she may have autism:

Quote:
“Her speech was very meager and expression of ideas completely lacking. She had difficulties with her pronouns and would repeat ‘you’ and ‘I’ instead of using them for the proper persons.” She was first declared to be feebleminded, then schizophrenic, but after the parents separated (the children remaining with their mother), she “blossomed out.”


Hope this helps. I might be able to dig up some more references as well. I do have Asperger's original article as well, just not saved to my computer so I'd have to look it up in a book I have. He also describes differences between the kids he studied and kids with schizophrenia.

The name "autism" actually came from a term used in schizophrenia, by the way.



LostInSpace
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14 Aug 2008, 4:48 pm

Callista wrote:
Yes, but details... Like why they thought it was a kind of schizophrenia, and what they did to try to treat it, and who figured out it wasn't schizophrenia at all...


Both Kanner and Asperger recognized some similarities between their kids and kids with schizophrenia, but believed that the kids exhibited a different disorder. So I guess it was both of them who figured out it wasn't schizophrenia.



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14 Aug 2008, 4:49 pm

ChristinaCSB wrote:
I heard some where that children can't actually have schizophrenia, which to me makes sense because children live in fantasy world, but if you are an adult and you stuck in fantasy it's schizphrenia....?


Kids can have schizophrenia. There is a girl with schizophrenia at the school I work at. She hallucinates, among other things.



Woodpeace
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15 Aug 2008, 4:54 am

The earliest study I have found of schizophrenia in childhood is Schizophrenia in Children, H.W. Potter. American Journal of Psychiatry (1933) Vol. 89, pp. 1253-1271. It is summarised in the chapter Childhood schizophrenia, autism and Asperger's syndrome in Schizophrenia and Related Syndromes, R. J. McKenna. London and New York: Routledge, 2007.

Among the cases described by Potter was that of a young man who was 18 years old at the time of his study. He was:

Quote:
a morose irritable child who put on temper tantrums, usually with head banging. He rarely, if ever, displayed the usual amount of affection for his parents. He tended to be indifferent to his brothers and sister, except to one [younger] brother.

He made regular progress in school until about the age of nine.
Quote:
His talk became [at times] so incoherent that it was not possible to understand him. [...]

He was hospitalised at the age of 11. During the first 12 months of his stay, he spent the major part of his time gazing fixedly out of the window with a perplexed frown on his face, and at times could be found under the bed or crouched behind a piece of furniture. [...] His speech was voluble at times but irrelevant, disconnected and full of neologisms. His replies to most questions were a stereotyped, colourless 'I don't know'.

After about a year, he showed improvement and became more communicative. He went to a summer camp
Quote:
where he made a reasonably good adjustment in a negative, colourless fashion. He returned home and re-entered school where he made mediocre progress. He had to be re-admitted a year later, after which time he went downhill rapidly. When followed up at the age of 18, he showed obvious deterioration and was chronically hospitalised in a state institution.

I don't know if nowadays he would be diagnosed as being on the autism spectrum.

The cases described by Potter (1933) and by J.L. Despert in Schizophrenia in Childhood . New York: Brunner/Mazel, 1968, found that child schizophrenia began before the age of 7 and tend to present with features of behaviour and of speech such as:
Quote:
facial grimacing, posturing, marked underactivity, freezing, waxy flexibility, stiff gaits, playing with fingers, picking up bits of paper and arranging them in rows. [...] Speech sometimes became inarticulate or unintelligible, or took the form of an uninterrupted flow of disconnected utterances, with answers to questions being totally irrelevant; neologisms could be observed.


I have done research on the subject of child schizophrenia, some of which I will post here later.



anbuend
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15 Aug 2008, 5:04 am

It came to be differentiated from schizophrenia, because whenever they find a different cause/name/whatever for something that was considered schizophrenia in the past, they proceed to say it isn't "real schizophrenia" after all, and move it out of that category.

But despite the fact that this isn't the first or the last thing to be moved out of the category of schizophrenia, they too rarely question whether there is such a thing as "real schizophrenia". They're starting to get it, but instead of coming up with a better name for all the various things that are called that, they're just calling it "the schizophrenias" (which doesn't solve the fact that they're not all the same thing).

Personally, I find the question "How is Thing X different from Thing Y?" meaningless, when Thing Y isn't a Thing at all. It's like asking "How is syphilis different from neurasthenia?" Yes, lots of people with syphilis (and multiple sclerosis, and depression, and...) were once diagnosed with neurasthenia, but today neurasthenia is known to not be a valid category to begin with.


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Danielismyname
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15 Aug 2008, 5:06 am

The ICD calls Childhood Autism "Infantile Psychosis" in its list of naming conventions (Kanner's Syndrome, Autistic Disorder and Infantile Autism are the others).



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15 Aug 2008, 12:58 pm

Here is a link to the introductory pages and chapter I (Childhood psychoses and schizophrenia: a historical review) of Schizophrenia in children and adolescents edited by Helmut Remschmidt. Cambridge University Press, 2001: http://assets.cambridge.org/052179/4285 ... 4285WS.pdf .

C. Bradley and M. Bowen in Behavior Characteristics of Schizophrenic Children. Psychiatric Quarterly (1941), 15, pp.298-315, listed eight symptoms they considered to characterize childhood schizophrenia as found in twelve children (aged seven to ten years old) in an institution, whom several clinicians agreed were schizophrenic or severely schizoid. The symptoms are as follows:

1. Seclusiveness.

2. Irritability.

3. Daydreaming.

4. Bizarre behaviour.

5. Diminution of interests.

6. regressive nature of personal interests.

7. Sensitivity to comments and criticisms.

8. Physical inactivity.

Seclusiveness is defined as "a tendency frequently pathological of an individual, to cut himself off from social intercourse."
Symptoms #1, 2, 4, 6 and 7 were necessary for a diagnosis of schizophrenia. In addition there had to be "general impairment of social functioning".



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15 Aug 2008, 1:08 pm

Frances Tustin also wrote a book that differentiated the two, although even what she called childhood schizophrenia, is now known to be autism. (Especially, but not all, 'regressive' autism.)


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Woodpeace
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16 Aug 2008, 6:44 am

anbuend wrote:

Quote:
they too rarely question whether there is such a thing as "real schizophrenia".

In her book Schizophrenia: A scientific delusion? London and New York: Rouledge (1990), Mary Boyle, a British psychologist, challenges the scientific status of the concept of schizophrenia and argues that the claims made for 'schizophrenia' are not justified.

She states that
Quote:
It is readily agreed that 'schizophrenia' is an unobservable, an abstract concept inferred from overt behaviour or from verbal reports of behaviour and experience

But the same can be said for autism.

I believe that schizophrenia is a useful term for diagnosing people who present with what are designated as schizophrenic symptoms: auditory and/or visual hallucinations, delusions, thought disorder (whatever that is), etc. What other diagnosis could John Nash, for example, have been given? He had paranoid delusions.

anbuend wrote:
Quote:
lots of people with syphilis (and multiple sclerosis, and depression, ...) were once diagnosed with neurasthenia

I am very suprised that people with syphilis were once diagnosed as having neurasthenia. Syphilis has been known in Europe since at least 1494 when it was supposedly brought back from the West Indies by sailors who had sailed with Christopher Columbus in his first voyage there. They then fought in the French army in Italy and spread the disease there. The word is first used in an Italian poem published in 1530 in which the central character is a shepherd who is infected with the disease.

Syphilis has definite physical symptoms. Surely it was known by the 19th century, if not earlier, that it is usually contracted through sexual contract.

The entry for neurasthenia in the International Encylopedia of Psychiatry, Psychology, Psychoanalysis, & Neurology (1977) defines it as
Quote:
a descriptive term that implies a state of chronic fatigue associated with vague physical discomforts of presumably psychogenic origin. [...] George Miller Beard introduced the term in 1869 with his paper, Neurasthenia (Nervous Exhaustion) and Morbid Fears as a Symptom of Nervous Disease. It is one of the few psychiatric terms that has originated in the United States.
Beard tried to differentiate types of neurasthenia
Quote:
which were specific to different parts of the body (e.g., sexual, digestive, spinal, cerebral).

The term dementia paralytica or General Paralysis of the Insane was used from the early 19th century for the stage of syphilis in which the central nervous system has become inflammed. Mary Boyle describes how in 1912 convincing direct evidence established the link between dementia paralytica and syphilis.



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16 Aug 2008, 7:25 am

Of note, Asperger thought that Kanner's Disorder was some form of psychotic process (Schizophrenia), rather than the stable personality trait of his disorder.

Which has been proven wrong, but there it is.

Schizophrenia, the modern mental illness, is a "real" condition of relapsing and remitting periods of psychotic features (delusions/hallucinations), and the possibility of social withdrawal ("autistic aloneness").

The chronic types of Schizophrenia that have been described over the years [which predominately feature the "autistic aloneness", obsessive interests, etcetera), are probably closer to ASDs than the mental illness above.



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16 Aug 2008, 9:05 am

Woodpeace wrote:
I believe that schizophrenia is a useful term for diagnosing people who present with what are designated as schizophrenic symptoms: auditory and/or visual hallucinations, delusions, thought disorder (whatever that is), etc. What other diagnosis could John Nash, for example, have been given? He had paranoid delusions.


Why is it useful to use a term created by a guy who thought that paranoid delusions, a movement disorder, and general confusion and progressive inability to care for oneself, ought to share the same label just because he happened to think that they were all caused by the same thing?

Just because the label is there doesn't strike me as a good enough reason. They make up new labels all the time that explain things better, why not take a good look at the various things now called 'schizophrenia' and start over?

It's not at all like autism (I don't know if it was you or someone else who said that), because autism has unifying features underlying the differences. Schizophrenia doesn't. Bleuler thought it did, but it doesn't. And that is evidenced by the large number of things (autism included), that were once considered part of schizophrenia and now are not, making it essentially a diagnosis for "what's left over when all the things that have been moved out of this category are seemingly ruled out" -- an absence of being something else, rather than the presence of being something truly specific.

Quote:
I am very suprised that people with syphilis were once diagnosed as having neurasthenia. Syphilis has been known in Europe since at least 1494 when it was supposedly brought back from the West Indies by sailors who had sailed with Christopher Columbus in his first voyage there. They then fought in the French army in Italy and spread the disease there. The word is first used in an Italian poem published in 1530 in which the central character is a shepherd who is infected with the disease.

Syphilis has definite physical symptoms. Surely it was known by the 19th century, if not earlier, that it is usually contracted through sexual contract.


None of which changes the fact that it was diagnosed that way fairly frequently at the time. Simply knowing the existence of something in the abstract, does not mean it was not often diagnosed a certain way in the concrete. People had to note in books of the time (do a google books search on syphilis and neurasthenia) what the difference was, because they could be "mistaken" for each other. But of course, in the end, only syphilis turned out to be a valid medical condition.


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