Schizophrenia in adolescence

The emergence of schizophrenic psychoses during middle and late adolescence poses the question of how adolescence as a developmental stage is related to the emergence of severe psychopathology. This paper examines several possible explanations for adolescence as the beginning of the high-risk age, particularly for the schizophrenias. After discussing the nature of adolescence as distinguished from puberty, and then considering the nature of schizophrenia, we report some data from a long-range study of young adult psychiatric patients, both schizophrenic and nonschizophrenic. Our data support the idea that serious psychopathology—not only schizophrenia—occurs in a setting of poor competence in a variety of crucial skills which include the social, intellectual, and physical realms. The demands made on adolescents by societal expectations for independence and role establishment summon a variety of competencies. Where these competencies are dysfunctional, societal demands strain an already vulnerable youth, and potentiate disorganization.This work is supported in part by Public Health Service grants MH-05519, MH-18991, and MH-19477.This research is part of a program investigating schizophrenia which is being conducted jointly by the Psychosomatic and Psychiatric Institute of Michael Reese Hospital, the Department of Psychiatry, Pritzker School of Medicine, University of Chicago, and the Illinois State Psychiatric Institute.Received his Ph.D. in psychology from the University of Kansas. His research has been in individual consistencies in cognition and perception, and more recently in perceptual aspects of severe psychopathology. He was for 22 years on the senior staff of the Menninger Foundation, where he performed clinical and research functions, including that of Training and Supervising Analyst in the Topeka Psychoanalytic Institute, and Director of Research Training. He currently is a recipient of a Career Scientist Award from the NIMH (K5-MH-70900).Received his medical degree from Rush Medical College in Chicago. His psychiatric and psychoanalytic training took place in Chicago, Vienna, Zurich, Hamburg, and London. His research has been in psychosomatic medicine, stress and anxiety, clinical syndromes (including schizophrenia), normal development, and psychotherapy.