Long-term stability of diagnosis and symptom dimensions in a systematic sample of patients with onset of schizophrenia in childhood and early adolescence. I: nosology, sex and age of onset

Br J Psychiatry. 1996 Sep;169(3):361-70. doi: 10.1192/bjp.169.3.361.

Abstract

Background: Little is known about the long-term outcome of schizophrenia that has its onset during childhood and early adolescence (early-onset schizophrenia, or EO-SZ). Whether or not EO-SZ is an aetiologically separate form of schizophrenia (SZ) is unresolved.

Method: The study was a 14.8-year follow-up, using methods such as systematic sampling, evaluation of possible non-respondent bias, consensus best-estimate diagnoses (DSM-III-R) made independently in childhood and adulthood, measures of positive and negative dimensions, of non-psychotic behaviour disturbances (NPBD) and of developmental problems before the appearance of SZ.

Results: There was high stability of EO-SZ (n = 40) diagnoses (mean onset at 14.0 years) until adulthood (mean age at follow-up 28.8 years) but a lower stability of positive and negative schizophrenic dimensions. There was a poor outcome of EO-SZ, a strong over-representation of males but few gender differences, and no effect of age of onset on clinical features and outcome.

Conclusions: EO-SZ taken as a whole shows no qualitative differences to adult-onset SZ. However, a distinction through the onset of preschizophrenic developmental problems or NPBD might be a way to investigate heterogeneity within EO-SZ.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Personality Development
  • Psychiatric Status Rating Scales
  • Quebec
  • Risk Factors
  • Schizophrenia / classification
  • Schizophrenia / diagnosis
  • Schizophrenia, Childhood / classification
  • Schizophrenia, Childhood / diagnosis*
  • Schizophrenia, Childhood / psychology
  • Schizophrenic Psychology
  • Schizotypal Personality Disorder / classification
  • Schizotypal Personality Disorder / diagnosis
  • Schizotypal Personality Disorder / psychology
  • Sex Factors