Predicting outcome in child and adolescent (early onset) schizophrenia and bipolar disorder

Fifty-nine patients with DSM-III-R early onset (mean, 13.9 years) psychoses of schizophrenia (N = 30) or bipolar disorder (N = 23) were seen at follow-up (mean interval, 5 years; mean age, 19 years). About 50% of the variance in outcome was predictable using stepwise multiple correlation, which has the advantage of eliminating redundancy among variables and giving a quantitative estimate for each predictor. Abnormal premorbid adjustment/personality and degree of recovery after initial hospitalization were the substantial predictors in schizophrenia, whereas in bipolar disorder, they were premorbid adjustment and IQ. Other items such as diagnosis (bipolar or schizophrenia), symptoms, and gender predicted at too low a level to be useful clinically. Though psychosis is necessary for diagnosis, premorbid personality abnormality may be an indicator of an early onset, developmental type schizophrenia with poor prognosis.