[Follow-up dynamics of schizophrenic diseases in adolescence]

In the present study the clinical features of the first episode of schizophrenia were investigated retrospectively and the initial symptomatology was compared with follow-up findings. The study group consisted of 40 adolescents with chronic schizophrenia. During a one-year follow-up period positive and negative symptoms of schizophrenia and depressive symptomatology were evaluated every six weeks. When the patients entered the follow-up study the mean duration of their illness was 4.3 years. Our data revealed a close link between positive and negative symptoms during the period studied. Persistent positive symptomatology at the end of the first treatment period was predictive of high scores for positive and negative symptoms during the entire follow-up period. Furthermore, we were able to demonstrate that negative symptoms can be distinguished from depressive symptoms in the context of the schizophrenic symptomatology. Depressive states (Brief Psychiatric Rating Scale, BPRS) were closely related to the positive symptoms (assessed with the Andreasen scale SAPS), and the negative symptoms (SANS) were correlated with the anhedonia score on the BPRS. Our results suggest that productive symptomatology should be treated aggressively both initially and for a prolonged period of time thereafter. Positive and negative symptoms appear to be related to each other longitudinally. Thus we postulate a single disease process rather than two distinct types of adolescent schizophrenia.