The Aetiology of Schizophrenia in Childhood

Extract

The aetiology and significance of schizophrenia in childhood is still so obscure that it is profitable to analyse fully every case that is diagnosed. In the United States of America, where cases appear to occur more frequently, the picture of full-blown childhood schizophrenia has been well drawn by Bender, Kanner, Szurek and others, but the descriptions are more of the whole forest and the details of the individual tree are missed in the whole. Excellent individual studies certainly are made, but the significance is often not understood, as if the workers were more used to macroscopic than to microscopic studies, but an unforgettable demonstration of the gross pathology and clinical picture of childhood schizophrenia is given at the Langley Porter Clinic in San Francisco. The over-all impression is one of emotional fixation at the infant to toddler level. In a variety of cases all stages may be shown from the oral to the anal level of erotism, from the delight and practice of bodily movements at rest and in space, to the experiments and flights in fantasy of the later period. Play is also at the toddler or earlier level—one child of ten years came offering everyone cups of imaginary coffee to drink—and there is the same lack of team spirit, the same failure to make groups of more than two for any length of time, the same mischievous exploratory tendency, the same perseveration tendency with any trick, the same range of comfort mechanisms from thumb-sucking to rocking and masturbation, the same range of speech from babble to sentences as is found in any nursery and nursery school, although the chronological age-range may be five to fifteen years instead of six months to five years.