Citation

Poletti M, Raballo A. Lancet Psychiatry 2023; 10(5): e314.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/S2215-0366(23)00074-3

PMID

37059477

Abstract

The study by Birgitte Klee Burton and colleagues, which capitalises on the follow-up of a large cohort of offspring of individuals with a diagnosis of schizophrenia or a diagnosis of bipolar disorder, marks a step forward in the characterisation of early endophenotypic expressivity of the putative genetic predisposition for schizophrenia (ie, schizotaxic risk). The study confirms that in those children, early childhood motor impairment persists into pre-adolescence (from age 8 to 12 years) and is also associated with the risk of psychotic experiences.

This risk amplification pattern points to the prognostic relevance of early developmental phenotypes and strengthens the rationale for incorporating them in predictive models for psychosis. Early neurodevelopmental deviations in the motor domain have been repeatedly indicated as suggesting a higher risk of psychotic experiences, from subthreshold trait-like schizotypal personality features to full-blown schizophrenia.

Nonetheless, it remains underexplored, both theoretically and clinically, why the motor domain is apparently more salient and intimately associated with psychotic risk than other neurocognitive domains. In other words, do childhood motor problems represent something more than just one of many neurocognitive epiphenomena of an altered neurodevelopment?

Language: en