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The Iron Triangle of Familiarity for Severe Mental Illness, Developmental Coordination Disorder and Risk of Psychosis: Recognize to Prevent

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Abstract

Purpose of Review

Despite increasing evidence on the association between childhood motor problems and the subsequent risk of psychosis, at least in offspring of patients with severe mental illness, this possible heterotypic outcome of children with Developmental Coordination Disorder (DCD) remains undervalued and poorly acknowledged. This review therefore aims to examine this possible longitudinal association and its possible neurophysiological bases.

Recent Findings

Offspring of individuals with schizophrenia who exhibit motor dyscoordination are more likely to subsequently develop psychosis, according to prospective studies. A recent longitudinal study strongly confirmed that especially the genetic risk for schizophrenia is associated with childhood motor problems, up to a possible DCD diagnosis in a third of cases, and that in early adolescence, there is an intimate bidirectional association between motor impairment and psychotic experiences. Neurophysiological studies suggest that the common alteration of corollary discharge may have a direct effect on motor coordination and an indirect effect to the risk of psychosis through the intermediate progressive fading of the feeling of agency.

Summary

Genetic risk for schizophrenia or severe mental illness in infancy + motor impairment up to a diagnosis of DCD in childhood + risk for psychotic manifestations in adolescence constitute an iron triangle of distinct developmental manifestations in distinct developmental stages.

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  1. Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Service, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy

    Michele Poletti

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Poletti, M. The Iron Triangle of Familiarity for Severe Mental Illness, Developmental Coordination Disorder and Risk of Psychosis: Recognize to Prevent. Curr Dev Disord Rep 10, 286–292 (2023). https://doi.org/10.1007/s40474-023-00286-4

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