Longitudinal course of schizophrenia spectrum symptoms in offspring of psychiatrically hospitalized mothers

The aim of this study was to describe schizophrenia spectrum symptoms (SZSD) in children and adolescents with schizotypal personality disorder (SPD) as adults. There are no descriptive studies of children who develop into adults with SPD. Twelve offspring of psychiatrically hospitalized mothers (6 mothers with schizophrenia), were compared with 11 socioeconomic status (SES)-matched offspring of control, non-ill mothers. Offspring were evaluated clinically and psychometrically between infancy and 2, 10, 15 years of age, and adulthood. Adult Axis I and II diagnoses were made blind to infant and parent status. Six hospitalized mothers were diagnosed with schizophrenia, 6 with other severe psychopathology. Offspring with SZSD more likely had schizophrenic mothers, and childhood deteriorating IQs, symptoms of social isolation, constricted affect, digressive speech, suspiciousness, and excessive social anxiety. Global assessment scores in SZSD offspring were lower in childhood and adulthood than comparison offspring. Children with SZSD met currently accepted criteria for schizotypy; 3 by 10 years of age, and 2 by 19 years of age. Differential diagnosis is discussed. An appendix of case histories is presented.