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Diagnostic stability in adolescent onset psychotic disorders
Håkan Jarbin1, Anne-Liis von Knorring
1Department of Child and Adolescent Psychiatry, University Hospital, Uppsala, Sweden.
European Child & Adolescent Psychiatry
|February 26, 2003
Summary
Adolescent psychotic disorder diagnoses are generally stable long-term. However, a small group initially diagnosed with affective disorders later developed schizophrenia spectrum disorders, often with a family history of psychosis.
Area of Science:
- Psychiatry
- Developmental Psychology
- Clinical Neuroscience
Background:
- Early onset psychosis in adolescence presents diagnostic challenges.
- Understanding the long-term diagnostic trajectory is crucial for effective treatment.
Purpose of the Study:
- To assess the long-term diagnostic stability of psychotic disorders in adolescents.
- To investigate patterns of diagnostic change over time in this population.
Main Methods:
- Longitudinal follow-up of 68 patients with first-episode early onset psychosis (aged <19).
- Average follow-up duration of 10.5 years.
- Utilized Positive and Negative Symptom Scale and lifetime Structured Clinical Interview for DSM-IV.
Main Results:
- Initial diagnosis split between schizophrenia spectrum and affective disorders showed high (>80%) positive predictive validity and sensitivity.
- A subgroup (n=6) initially diagnosed with affective disorder shifted to schizophrenia spectrum disorder.
- These 'change' patients shared premorbid/prodromal traits with stable affective and schizophrenia groups, but exhibited poorer outcomes than the affective group.
- Family history of nonaffective psychosis was common in the 'change to schizophrenia' group.
Conclusions:
- Diagnoses of schizophrenia spectrum or affective psychotic disorder in adolescence are typically stable.
- A distinct subgroup of adolescents with non-schizophrenia psychotic disorders may evolve into schizophrenia spectrum disorders over time.