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Premorbid functioning in early-onset psychotic disorders.

Jon McClellan¹, David Breiger, Chris McCurry

¹Department of Psychiatry, University of Washington, Seattle 98195, USA. drjack@u.washington.edu

Journal of the American Academy of Child and Adolescent Psychiatry

|August 19, 2003

Summary

Early-onset psychotic disorders in youth often present with premorbid behavioral and academic issues. Schizophrenia is linked to social withdrawal, while psychosis NOS may involve abuse histories.

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Area of Science:

Child and Adolescent Psychiatry
Developmental Psychology
Neuroscience

Background:

Early-onset psychotic disorders (EOPD) represent a significant challenge in child and adolescent mental health.
Understanding premorbid characteristics is crucial for early identification and intervention strategies.

Purpose of the Study:

To investigate the premorbid functioning and characteristics of youths diagnosed with early-onset psychotic disorders.
To identify distinct premorbid patterns associated with specific psychotic diagnoses in youth.

Main Methods:

A cohort of youths with EOPD underwent comprehensive diagnostic evaluations.
Premorbid functioning was assessed using the Premorbid Adjustment Scale through historical review.

Main Results:

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Across all EOPD groups, high rates of premorbid behavioral problems and academic difficulties were observed.
Youths with schizophrenia exhibited significantly higher rates of social withdrawal and global impairment compared to other groups.
The psychosis not otherwise specified (NOS) group showed elevated rates of abuse histories and posttraumatic stress disorder (PTSD).

Conclusions:

Premorbid abnormalities are prevalent in youths with EOPD, suggesting a developmental trajectory.
Social withdrawal and peer difficulties in schizophrenia may indicate early negative symptoms.
Abuse histories in the psychosis NOS group could contribute to atypical psychotic symptoms, potentially related to trauma.