The course and outcomes of episodic endogenous psychoses with juvenile onset (a follow-up study)

A clinical follow-up study (mean follow-up period 16.8 +/- 6.4 years) of 278 patients with juvenile-onset endogenous episodic psychosis (Endogenous Psychosis Episodic Type, EPET -- ICD-10 F20.03, F20.23, F25) with first episodes in 1984-1995 was performed. The period of the most intense occurrence of repeated episodes occurred during the first five years from the initial episode (almost all repeat episodes in the patients occurred during this period). At the time of the follow-up study, "good" outcomes were seen in 18.7% of patients, "relatively good" in 33.8%, "relatively poor" in 30.2%, and "poor" in 17.2%. Analysis of correlations between disease course and outcome and types of manifest episode and a number of clinical-pathogenetic parameters yielded several statistically significant criteria for clinical and social prognosis. Nosological evaluation at the time of the follow-up study showed that 76.2% of patients had schizophrenia (episodic progressive in 61.1%, recurrent in 15.1%) and 28.3% had schizoaffective psychosis. Comparison of the data with results from previous analogous studies led to the conclusion that the contemporary pathomorphosis of EPET is more favorable, with trends to improvements in disease course and outcome, decreases in progression, and significant reductions in cases of transition to a chronic course.