Clozapine-Aripiprazole Association in a 7-Year-Old Girl with Schizophrenia: Clinical Efficacy and Successful Management of Neutropenia with Lithium (Case Study‪)‬

EVEN THOUGH THE DIAGNOSTIC and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association 1994) defines very-early-onset schizophrenia (VEOS) as when the onset occurs before the age of 13 years, fewer than 20% of the patients diagnosed as VEOS are actually younger than 10 years. Compared with the adolescent and adult form of the disorder, the earliest form of the disorder is much more frequently associated with poor premorbid function in all the domains of development (motor, speech, and social) (Masi et al. 2006). The onset is usually insidious in young children, because only 25% present an acute onset (Werry and McClellan 1992). Auditory hallucinations are the most frequent positive symptom, whereas delusions are usually less complex than in adolescent schizophrenia and are usually related to childhood themes (Masi et al. 2006). Negative symptoms are usually predominant, namely flat or inappropriate affect, avolition, and poverty of speech, and most patients present a marked deterioration from a previous level of functioning (Masi et al. 2006), with poor long-term prognosis (Hollis 2000).