Laboratoire Psychologie de la Perception Institut Neurosciences Cognition Université Paris Descartes Centre National de Recherche Scientifique
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Les troubles du developpement de l'image du corps dans la petite enfance: Une dimension commune partagee par la schizophrenie et l'autisme?

The relationship between autism and schizophrenia has been subject of debate since the very appearance of the term "autism" in the nosography, and led to many studies with contradictory results. This question remains current and is nowadays the focus of renewed interest on the part of both clinicians and researchers. This article analyzes the clinical cases of two brothers. One showed autism in early childhood (according to the diagnostic criteria of the American and WHO classifications, and Kanner autism according to the French classification), with severe impairments in social communication and psychomotor development (diurnal and nocturnal enuresis and encopresis persisting until the age of 14, balance impairment, and severe fine and gross motor skill problems), which evolved towards very early onset schizophrenia (mixed form) at 11 years of age, whereas he had not yet entered puberty. His brother displayed psychomotor development impairments in early childhood (nocturnal enuresis persisting to the age of seven years, motor stereotypies that disappeared towards five years of age, substantial fine motor coordination problems still present in adulthood with later progressive deterioration of gross motor skills), and became schizophrenic (deficit form) at the age of 17 (schizophrenia with onset marked by dysmorphophobia associated with self-injurious behavior and withdrawal in terms of social communication). Based on these two clinical cases, the relationship between autistic disorder and schizophrenia is reviewed and discussed. In particular, we develop the hypothesis that developmental disorder in body image, already present since early childhood, may be a dimension common to schizophrenia and autism relevant to a possible problem in the development of body self conscience, leading to problems differentiating self/non-self, and consequently problems in social communication development that are expressed very early in some cases (when psychomotor development is highly altered) and at puberty in other cases (when psychomotor problems are less severe). The physical changes inherent to puberty, occurring in an already vulnerable individual may add to the pre-existing difficulties in body image construction and the development of body-self conscience, and therefore be a decompensatory factor participating in the onset of schizophrenia. (PsycINFO Database Record (c) 2009 APA, all rights reserved)