Children and schizophrenia - Research Paper Example

? Children and Schizophrenia CHILDREN AND SCHIZOPHRENIA Introduction Language and speech disorders, associated with schizophrenia,are common as a developmental problem during childhood. These disorders include language difficulties that exclude mental retardation and neurological disorders. Language impairment, however, does not happen in isolation. The presence of developmental language disorder comes with a significant risk of psychiatric, psychosocial, and academic disorders in childhood, which extend into adolescence, as well as childhood. The research study covered in this paper is one of the special longitudinal studies, which have sought to study the outcome of children with childhood DLD associated schizophrenia. Most of the other studies have mostly focused on academic achievement, cognition, and language skills. This study looks into results compiled from a study, which compared types and rates of schizophrenic disorders in a group of four hundred and sixty nine individuals diagnosed with developmental learning disorder as children by utilizing data from the Psychiatric Central register in Denmark. Literature review The literature review for this research study started with searches made in the PsycINFO electronic database for the period between 1872 and the week of fourth of November 2007. Of the total thirteen thousand nine hundred articles that appeared under child abuse and the forty two thousand that appeared under schizophrenia, twenty-three that resulted after the two classifiers were entered at the same time. Therefore, out of the author’s search, only 0.05% of the articles searched concerning schizophrenia had anything to do with child abuse. This is comparable to genetics that resulted in 4.1% of the search, neurotransmitters that accounted for 5.0%, the brain that accounted for 8.0% and drug therapy that accounted for 21.5% (Beitchmann et al, 2007). When the author expanded the search to include; emotional abuse, child neglect, physical abuse, and sexual abuse, forty-two results that related to schizophrenia presentation in children. Before the research paper was resubmitted in 2008, the author had repeated the searches and had found five additional studies linking the above with schizophrenia. It is, however, not clear why these studies were not included in the research study as they were more recent compared to the rest. Almost all the articles that the author used to make a direct relationship between child abuse and schizophrenia, however, are included in the study and review section. The author excluded studies that did not ask the patients on abuse via either questionnaires or protocols by providing particular instances of language deficiencies that could have resulted from child abuse, thus studies and chart reviews that merely asked the subjects whether they were abused as children without emphasizing on the language developmental aspect that the author excluded. By doing this, the author, may have unwittingly excluded other reasons that could lead to DLD and schizophrenia that were covered with research studies that did not involve research into the effects of abusive childhoods. The author also excluded studies that involved units serving various populations that were known to involve high rates of child abuse. The CSA rates were eighty seven percent in the PTSD unit and ninety two percent in units that served those with developmental learning disorder. However, the author could have included more studies where the data published was analyzed by type of childhood environment or even gender. Although, he claims that the authors of the studies did volunteer the necessary data when contacted, including this data would have been better since it would have made the research study more comprehensive. Methods The population used in the study involved a case group of subjects with developmental learning disorder. This encompassed four hundred and sixty nine out of four hundred and seventy two children that were referred to the Institute of Speech and Hearing, which acted then as a tertiary institution specializing in treatment and assessment of children presenting with developmental learning disorder (Beitchmann et al, 2007). The children in this institute were admitted after preliminary evaluation by local language and speech therapists. The children were only admitted into the institute for treatment and investigation if their basic handicap involved linguistic difficulties. Children with impaired hearing, disabilities in learning, or psychiatric difficulties were referred to other national institutions. The study would have been more comprehensive than it is, if the researcher would have also involved children from these other institutions in order to investigate the occurrence of schizophrenia more exhaustively. During three instances in the study, it was not possible to decipher the children’s PIN, and they had to be removed from the study. The first evaluation for DLD was inclusive of three weeks of observation for a group of children in kindergarten coupled to a comprehensive assessment of linguistic development (Beitchmann et al, 2007). It is also seen that, in order to ensure the assessment was homogenous, the researchers only used two speech therapists. In the study, the second author assessed two hundred and forty five children. Their IQ was assessed via the utilization of psychometric assessment in 324 out of 329 boys. Overall, one hundred and forty girls and one psychologist performed the IQ tests (Beitchmann et al, 2007). This is a bit confusing since the study states that the second author used 249 children. Despite attempts to comprehend, the connection between these and the 329 boys then mentioned this was in vain. The researchers also used a part of an earlier study that was inclusive of a review of the original case records used for classification of various types of problems related to DLD according to ICD-10 criterion (Cannon et al, 2007). Additionally, the researchers added a severity scale for severe impairment, moderate impairment, mild impairment, and no impairment. The researchers used this scale as a reflection of Denmark’s daily routines. However, it is clear that the scale was not designed for use in the study currently being reviewed. The researchers drew a comparison control group from the Central Persons register in Denmark that acted to provide data on the total population since it had past and current data on all individuals living and/or morn in Denmark (Cannon et al, 2007). Each child with DLD was matched to 5 children via time of birth and place of birth. Therefore, these 2,345 children were the ones who made up the study’s comparison study group. The study being reviewed is a register study. The study’s subjects were screened via the use of a national computerized DPCR that used their identity number, ensuring they were identified definitively (Cannon et al, 2007). This was used to enable the researchers follow the two groups’ histories with respect to night and day care in-patient admissions to departments of psychiatry within the period of thirty-six years over which the study was conducted, i.e. from April the 1st 1971 to February the 3rd 2007. It also included consultations made for outpatients at the psychiatric departments, as well as contact made with the psychiatric ER service from 1997. For the persons that were registered in DPCR, the researchers ascertained their admission locations and their discharge, as well as their diagnosis on discharge. One drawback was the lack of private Danish psychiatric institutions used in the study with all the admissions utilized in the study included in their register (Cannon et al, 2007). The patients were administered with ICD-8 diagnoses from April the 1st 1971, when the register’s computerized section was inaugurated, to December the 31st 1995 and ICD-10 diagnoses from 1st January 1996. The researchers recorded all patients with up to three subsidiary diagnoses. Both controls and cases used by the researchers were tracked from the DOB or for the ones born before April of 1971, from that particular date until the study’s endpoint. The average length of the study’s follow up came to 34.7 years with a range of 28-36.1 years and a standard deviation of 1.83 years for the two groups (Clegg et al, 2006). The average age at follow up for the research study came at 35.8 years with a standard deviation of 3.11 years and a range of 28.3 years to 46.7 years. For these calculations, the researchers assumed that individuals would remain alive throughout the period that the study covered, which was satisfactory. The members in the case study and their control groups were taken down via their discharge diagnosis. The researchers categorized the members of the cohort group as having disorder diagnosis in the schizophrenic spectrum. If they were discharged from the institution or had visited the outpatient department with a diagnosis ICD-8 code of 298.39, 297.09-297.99, 295.09-295.99 and an ICD-10 code reading F20-29, as well as having a disorder that possessed a diagnosis code of 298.19, 298.09, 296.09-296.99 for ICD-8 and F30-39 for the ICD-10 code for diagnosis (Clegg et al, 2006). For basic handling of data and analysis of the statistics derived, the researchers used the STATISTIX program. They compared the two groups based on 2-sample t-test and the chi-square test. However, it would also have been in order for researchers to use the Fishers Exact test in their dichotomous for absent and present data. They also used an un-weighted analysis for logistic regression in the identification of possible variables in childhood that association with broad schizophrenic disorder diagnostic categories. They also used a 0.05 probability level in their attempts to indicate differences that were significant. Results Thirty people, altogether, from the group compared to forty-three from the control group were recognizable from schizophrenia disorder diagnosis register at 30/469 (6.4%) against 43/2,345 (1.8%) with P Read More