Clinical and Developmental Predictors of Treatment Response in Children and Adolescents With Schizophrenia Spectrum...

Treatment response in early-onset schizophrenia spectrum disorders (SSD) is highly variable and poorly understood. Identifying clinical and developmental predictors of treatment response is crucial for optimising early interventions in psychotic adolescents.

We retrospectively analysed 197 children and adolescents with SSD admitted to a tertiary psychiatric inpatient unit between 2014 and 2022. Treatment response was defined as a ≥ 50% reduction in PANSS total score from admission to discharge. Univariable and multivariable logistic regression were used to analyse clinical variables (PANSS subscales, comorbidities, disease duration) and developmental factors (general developmental scale, learning difficulties at school).

Overall, 60.9% of patients met the treatment response criteria. Multivariable analysis identified comorbid OCD (OR = 0.27, p = 0.010) and education level (OR = 1.216, p = 0.011) as significant negative predictors of response. The PANSS negative score at admission showed a trend towards significance. Learning difficulties at school were associated with non-response in univariable analysis (p = 0.0463). The final model demonstrated good discriminatory ability (AUC = 0.70).

Our findings emphasise the importance of negative symptom severity, comorbid OCD and developmental learning disorders in predicting treatment outcomes in adolescents with SSD. These findings highlight the need for tailored interventions targeting neurodevelopmental vulnerabilities in early-onset psychosis.