[Follow-up of schizoaffective psychoses in adolescence]

Of 156 adolescent inpatients with psychotic disorders (ICD-9: 295.0 to 296.9), 25 had a schizoaffective psychosis with onset before age 18. Of these, 21 were followed up an average of 6.5 years later. Six of the subjects had had only one schizoaffective episode and 15 had had a second episode an average of 14 months later. Half of the subjects had had schizoaffective episodes only. More of the patients with an initial affective episode developed schizoaffective psychosis than of those with an initial schizophrenic episode. On average there had been 0.91 episodes per year during the follow-up period. Seventy-one percent of the subjects had been unable to continue their education or work at the previous level and most had marked deficits in social adaptation. The level of social competence at the end of the first episode was of predictive value for the later social handicap. A comparison with other groups of patients of the same age showed that those with affective disorders had faired better and those with schizophrenia appeared to have the poorest outcome. The schizoaffective group tended to resemble the schizophrenic group more closely than the affective group. Patients whose schizoaffective disorder began in adulthood had fewer problems on the educational and occupational level, better social adaptation and fewer episodes per year and had spent less time in inpatient treatment than those whose disorder had begun before age 18.