61 The real importance of the standardized diagnostic instruments is establishing diagnostic stability, symptom dimensions, clinical characteristics, and predictive validity. Long-term studies utilizing the same diagnostic tests over time62,63 indicate that there is stability of symptoms with the differentiation of features of the various illnesses and establishment of the clinical characteristics of the individual illnesses. A more recent example of symptom predictability

involved a prospective study of a birth cohort (n=761), who were given structured diagnostic interviews at age 11 years and then again at 26 years.64 The group was divided into those who had weak symptoms Inhibitors,research,lifescience,medical and strong symptoms based on the reports of hallucinations or delusions, their severity, and the presence of other Inhibitors,research,lifescience,medical symptoms meeting criteria for a psychotic disorder. No children were diagnosed with COS. Those children who reported strong symptoms were 16 times more likely to have a schizophreniform diagnosis by age 26 years. Furthermore, 90% of the strong symptom children had occupational and social dysfunction as adults. Even those children who reported weak symptoms were significantly more likely to meet diagnostic criteria for adult schizophreniform disorder. Forty-two percent of diagnosed schizophreniform

Inhibitors,research,lifescience,medical cases at age 26 interviews were Tasocitinib datasheet associated with the presence of either weak or strong symptoms at age 11 years. The authors Inhibitors,research,lifescience,medical suggest that children experiencing hallucinations or delusions in the absence of a thought disorder may be experiencing prodromal changes, which could lead to the onset of frank psychotic symptoms. Rating scales Once a diagnosis has been established, rating scales are useful for monitoring symptoms Inhibitors,research,lifescience,medical of psychotic disorders during treatment and over time. Useful pediatric rating scales include the Child Depression

Rating Scale (CDRS)65 and the Kiddie Version of the Positive and Negative Symptoms of Schizophrenia (K-PANSS) for COS.66 Rating scales such as the Clinical Global Impressions-Severity and Improvement (CGI-S and CGI-I)67 and the Clinical Global Assessment of Function (CGAF)68 are also useful to measure severity of impairment both at diagnosis and over time for any psychiatric disorder. Research that may inform diagnostic Mephenoxalone testing in the future Genetics Evidence from twin, family, and adoption studies indicate genetic factors play an etiological role in schizophrenia.69 A possible susceptibility gene for schizophrenia is localized in the region 8p22-8p21.70 Studies of children with velocardiofacial syndrome (VCFS) suggest that chromosomal region 22qll.2 may have a role in development of schizophrenia because the autoso mal dominant syndrome sometimes leads to chronic paranoid schizophrenia.71 An ongoing study at the NIMH in 47 subjects with COS demonstrated that 5 patients (10.