DOI: 10.1192/j.eurpsy.2026.10577 ISSN: 0924-9338

Childhood-Onset Schizophrenia Spectrum Disorders: Neurodevelopmental Influences on Psychotic Symptoms and Psychopathological Profiles

M. Di Luzio, M. Pontillo, I. Bertoncini, B. D’Aiello, R. Averna, M. Labonia, S. Vicari

Introduction

Childhood-Onset Schizophrenia Spectrum Disorder (COSS) represent a very early-onset subtype of schizophrenia spectrum disorders, typically manifesting before age 13. Although interest in COSS has grown in recent years, studies exploring its clinical characteristics remain scarce.

Objectives

This study aimed to analyze clinical differences within the COSS group based on the presence of psychiatric or neurodevelopmental comorbidities to delineate distinct psychopathological profiles of childhood psychosis. We hypothesized that COSS presents variable symptomatology depending on the presence of comorbid psychiatric disorders, neurodevelopmental disorders, or the absence of comorbidities.

Methods

Seventy children diagnosed with COSS were selected at the onset of psychotic symptoms from admission to a specialized very early-onset psychosis clinical service. Participants were assessed and divided into three subgroups based on comorbidity profiles: COSS with neurodevelopment disorder comorbidity, COSS with psychiatric disorder comorbidity, COSS without psychiatric or neurodevelopmental disorder comorbidities. Psychotic symptoms were indexed using the Structured Interview for Psychosis-Risk Syndrome.

Results

The Statistical analysis of the subgroups revealed that COSS with neurodevelopmental disorder comorbidity exhibited a distinct profile, characterized by earlier onset of psychotic symptoms, lower intelligence quotient, greater disorganization symptoms, and fewer negative symptoms compared to COSS with psychiatric disorder comorbidity. COSS with psychiatric disorder comorbidity and COSS without comorbidities showed more similarities with each other than with COSS with neurodevelopmental disorder comorbidity, suggesting a significant influence of neurodevelopmental comorbidities on clinical presentation.

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Conclusions

Identifying specific psychopatological profiles within COSS may enhance personalized treatment approaches for COSS, as well as for early-onset and adult-onset schizophrenia spectrum disorders.

Disclosure of Interest

None Declared

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