Baseline profiles of adolescent vs. adult-onset first-episode psychosis in an early detection program

Acta Psychiatr Scand. 2009 Jun;119(6):494-500. doi: 10.1111/j.1600-0447.2008.01338.x. Epub 2009 Feb 5.

Abstract

Objective: Psychotic disorders often start in adolescence. We aim to investigate premorbid and baseline differences characterizing patients with an onset of psychosis in adolescence versus adulthood.

Method: We compare first-episode, DSM-IV non-affective psychosis with onset before (n = 43) and after (n = 189) 18 years on duration of untreated psychosis (DUP), level of symptoms, suicidal behaviour, and other baseline clinical and demographic characteristics.

Results: Adolescent onset patients had poorer premorbid functioning, a longer DUP, higher suicidality, and more depressive symptoms. They also had better cognition, fewer psychotic symptoms, and were more likely to be treated on an out-patient basis.

Conclusion: Adolescents with first-episode psychosis may have a slower and more silent, i.e. insidious onset, and are at risk of experiencing longer treatment delays than adults. They fit the description of what used to be labeled process (versus reactive) schizophrenia.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Adult
  • Age of Onset
  • Diagnostic and Statistical Manual of Mental Disorders
  • Early Diagnosis*
  • Female
  • Humans
  • Male
  • Prognosis
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis*
  • Risk Factors
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology
  • Suicide / psychology
  • Time Factors