A Longitudinal Study of Schizophrenia in Adolescence: I. The One‐ to Three‐Year Outcome

Abstract

In an attempt to evaluate retrospectively the three‐year course and outcome of treated adolescent schizophrenics, the medical data of 19 patients were collected from the first admissions over a period of 10 years (1971‐1981). According to the DSM‐III criteria, 17 were diagnosed as having schizophrenic disorders and the remaining 2 were schizophreniform disorders. The outcome at the time of first‐ to third‐year follow‐up was assessed on the outcome rating scale. The three‐year outcome was favorable with respect to both the length of hospitalization and the presence of psychotic symptoms. However, there was a sustained impairment in occupational (or scholastic) functioning throughout the three‐year follow‐up period. The female sex and the initial diagnosis of schizophreniform disorder might be factors affecting the good third‐year clinical (or symptomatic) outcome. The younger age at onset, the longer duration of the prodromal phase, and the longer period of time between the onset and the first presentation appeared to predict the poor third‐year occupational outcome.

A systematic review of the long-term outcome of early onset schizophrenia

“…Since the 1990s, there has been an increasing reliance on DSM-IV and ICD-10 criteria. In 16 studies consisting of 592 patients, the mean age at onset was 14.9 (SD = 1.6) years; five studies reported only age ranges [6,8,11,49,51]. …”

“…In 20 studies based on 707 patients, a total of 394 males (56.5%) were included. Repeated follow-up assessments were based on six samples and findings were described in nine articles [8,11,29,35,41,53,54,59,60]. Unfortunately, the data from these studies are not suited for repeated measurement analysis because both the sample sizes between follow-up periods (except [11]) and the duration of follow-up differed considerably.…”

“…Furthermore, the analysis was based on a series of cross-sectional rather than longitudinal studies. Unfortunately, among the 21 outcome studies of the present analysis, there are only six samples that were assessed repeatedly for follow-up and were described in 9 articles [8,11,29,35,41,53,54,59,60]. The study by Krausz and Müller-Thomsen [11] showed an increase in the proportion of “good” outcome from the first follow-up at 5 years to the second follow-up at 11 years (19 to 31%), whereas the rate of “poor” outcomes declined (74 to 59%) with a rather constant proportion of “moderate” outcomes (7 to 10%).…”

“…In two studies [6,29] ratings were based on outcome scales, whereas the ratings in the remaining nine studies [1,8,11,15,18,38,41,49,54] were based on categorical outcome measures. Based on the above-mentioned three categories of outcome and using the same cut-off scores, the three authors of the current study performed the ratings independently in each study.…”

“…Multiple studies noted sex differences without reporting stratified data. Time period of diagnosis considered studies including patients diagnosed before and after 1970 (<1970+) [1,6,18,23,29,32,49] and studies with all patients diagnosed in 1970 and later (≥1970) [5,8,11,15,34,36,38,40,41,52,53,55]. …”