Introduction

Our understanding of the biological basis of childhood neuropsychiatry disorders has improved dramatically over the past two decades. Some would argue that the advances made in understanding the biological basis of childhood disorders have outstripped those for adult-onset disorders. This improved understanding has been made possible primarily by technological advances in the fields of genetics, molecular biology, and neuroimaging. Many childhood neuropsychiatric illnesses have a strong genetic basis, and the application of the methodologies for family and genetic studies have begun to identify the precise genetic determinants for several of these conditions. In addition, the introduction of magnetic resonance imaging (MRI) as a research tool in the 1980s has allowed the safe study of brain tissue in living children over time, and this has helped immensely to identify the neuroanatomical and functional correlates of disease throughout development in the majority of childhood illnesses. Findings from

Textbook of Biological Psychiatry. Edited by Jaak Panksepp Copyright © 2004 by Wiley-Liss, Inc. ISBN: 0-471-43478-7

genetic, molecular biological, and brain imaging studies have helped to refine clinical phenotypes that have helped guide and improve studies that employ these biologically based methodologies in the study of brain disorders in children.

No single review can cover adequately the entire range of biological findings for all childhood neuropsychiatric disorders, nor the range of therapies for these many conditions. Our aim here is therefore to provide an overview of many of the most dramatic and important advances in our understanding of the biology of these illnesses. Those advances, and the research strategies that made them possible, will likely serve as models or paradigms for future biologically based research of disorders in which recent advances have not been as dramatic. Thus the conditions considered herein will be those within the broad domains of pervasive developmental disorder and specific genetic conditions (autism, Rett syndrome, fragile X, Williams syndrome, Angelman and Prader-Willi syndromes), childhood-onset schizophrenia, and disorders of impulse control (especially Tourette syndrome, obsessive-compulsive disorder, and attention deficit hyperactivity disorder). Wherever possible, discussion will include a review of the clinical phenotype, genetics, neurochemistry, and neurobiological substrate for each disorder. We will suggest ways in which findings in each of these domains relate to one another, so as to provide a coherent understanding of the pathophysiology of the condition. Many more references exist for the numerous findings that are cited herein; because of space constraints, only the most recent have been included.

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