The burden of early onset psychosis: Diagnostic complexity, high comorbidity, and poor functioning in patients and...

The Early Psychosis Investigation Centers in Mexico (EPIMex) and Boston (EPICenter) recruit children and adolescents with early onset psychosis (EOP), their relatives, and controls to elucidate risk factors for EOP.

In Mexico, data were available for 860 EOP probands, 493 relatives, and 865 controls, and in Boston, for 120 EOP probands, 182 relatives, and 60 controls. Psychiatric diagnoses were ascertained using the Structured Clinical Interview for the DSM-V (SCID-5). General cognitive ability was calculated using 7 cognitive tests. Functioning and symptoms were ascertained with the Children's Global Assessment Scale or Global Assessment of Functioning scale, and the Brief Psychiatric Rating Scale, respectively. EOP probands, relatives with and without diagnoses, and controls with nonpsychotic diagnoses were compared to controls without diagnoses.

In Mexico, over 86 % of EOP probands had at least one psychiatric comorbidity, and 73 % of relatives had a psychiatric diagnosis, with 52 % having multiple diagnoses. In Boston, 77 % of EOP probands had at least one psychiatric comorbidity, and 80 % of relatives had a psychiatric diagnosis, with 42 % having multiple diagnoses. In Mexico, EOP probands, and relatives showed small cognitive deficits (effect size (ES) = 0.22-0.29, p < .05). In Boston, all groups showed large cognitive deficits (ES = 0.82-1.28, p = .001). Across both sites, all diagnostic groups (EOP probands, relatives and controls with diagnoses) showed poor functioning (ES = 0.87-1.92, p < .001), and severe symptoms (ES = 0.52-1.71, p < .02), and only 17 % of EOP probands showed "good" functioning (GAF/CGAS>70).

Early onset psychosis (EOP) is associated with high comorbidity, and poor functioning in patients, and their relatives.