Elevated Serum Levels of Homocysteine as an Early Prognostic Factor of Psychiatric Disorders in Children and Adolescents

Table 1

Clinical characteristic of patients groups [17–19].

	Development	Clinical characteristic	Affective disorders	Cognitive disorders	Therapy	Prognosis
Continuous course Sch	Gradual	Relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Volition and speech, and catatonic symptoms are either absent or relatively inconspicuous	Disturbances of affect. Affects that are inappropriate or blunted	Clear consciousness and intellectual capacity are usually maintained although certain cognitive deficits may evolve in the course of time	Often lasting usage of several antipsychotic medicine	Bad, progressing course with defect becoming deeper, resistance of therapy, disability
Episodic course Sch	Acute	Episodic with progressive or stable deficit, in the periods of exacerbation of disease symptoms like a continuous course Sch	Anxiety, fears	Early onset—have more significant deficits in measures of IQ, memory, and tests of perceptuomotor skills. Disturbances of working memory and attention	Aggravation therapy—commonly 2 antipsychotic medicaments, remissions—monotherapy	Bad, progressing course with defect becoming deeper, resistance of therapy, disability
Simple schizophrenia	Gradual	Simple schizophrenia is characterised with an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. The characteristic negative features of residual schizophrenia develop without being preceded by any overt psychotic symptoms	Cold or inappropriate affect, blunting of affect, and loss of volition	Early onset—have more significant deficits in measures of IQ, memory, and tests of perceptuomotor skills. Disturbances of working memory and attention	DRAs monotherapy, often combinations with AEDs	Bad. Gradual inellectual skills ↓, emotional disorders, formation of identity defect
Affective disorders—depressive episode, recurrent depressive disorders (with or without associated anxiety)	Subacute/; acute	Depression—the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced, and, even in the mild form, some ideas of guilt or worthlessness are often present. The lowered mood varies little from day to day, is unresponsive to circumstances, and may be accompanied by the so-called “somatic” symptoms, such as loss of interest and pleasurable feelings, waking in the morning several hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, weight loss, and loss of libido		Hard to concentrate, slow thinking rate	Antidepressant ± AEDs	Good, in case of duly treatment

Sch: schizophrenia; IQ: intelligence quotient; DRAs: dopamine receptor antagonists; AEDs: antiepileptic drugs.