Two Sides of One Coin: Affective Psychosis vs. Non-Affective Psychosis in Teenagers

Psychotic episodes in adolescents may present as affective psychosis (AP) or non-affective psychosis (NAP), which are clinically overlapping. This single-center, retrospective study aimed to describe and compare adolescents with AP and NAP regarding demographic characteristics, family history, academic functioning, and treatment patterns.

We retrospectively analyzed medical records of 171 patients aged 11-18 years admitted to the "Prof. Dr. Alexandru Obregia" Clinical Psychiatric Hospital, Bucharest, between 2020 and 2024. Descriptive statistics and univariate analyses were performed to explore associations between episode type and selected clinical and sociodemographic variables. An exploratory multivariate logistic regression was conducted to assess whether associations observed in univariate analyses remained stable after adjustment for relevant covariates. Treatment-related variables were analyzed descriptively and were not included as predictors in the regression model.

AP was more frequent in females (53.2%), whereas NAP predominated in males (62.8%, p = 0.036). Trends toward higher rates of psychiatric family history and better academic performance were observed in the AP group, while school dropout was more frequent in NAP, although these differences did not reach statistical significance. Mood stabilizers were prescribed more frequently in adolescents with AP, reflecting clinical practice patterns; however, this association did not reach statistical significance and was interpreted descriptively. In multivariate analysis, gender remained significantly associated with episode type.

This retrospective study identifies descriptive differences between adolescent AP and NAP in gender distribution, family psychiatric history, academic functioning, and treatment patterns. Findings are exploratory and do not imply causality. Results highlight areas for further research and underscore the importance of considering clinical subtype and functional outcomes when planning interventions in adolescent psychosis.