Child and Adolescent Onset Schizophrenia

Hollis, Chris

doi:10.1002/9780470987353.ch4

Cited by 3 publications

(3 citation statements)

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“…Hollis [ 10 ] reported that about one-fifth of patients in most studies have a good outcome with only mild impairment, while at the other extreme about one-third of patients are severely impaired requiring intensive social and psychiatric support. Limitations of previous studies included relative rarity of the disorder which reflected on the small sample size.…”

Section: Introductionmentioning

confidence: 99%

Long term functioning in early onset psychosis: Two years prospective follow-up study

Hassan

Taha

2011

Behavioral and Brain Functions

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BackgroundThere were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome.MethodThe study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level.ResultsAnalysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2%) had one episode, 23(62.1%) had multiple episodes and 8 (21.6%) continuous course. Nineteen patients (51.4%) achieved full remission, and only 11(29.7%) achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome.ConclusionSome patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.

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Section: Introductionmentioning

confidence: 99%

Long term functioning in early onset psychosis: Two years prospective follow-up study

Hassan

Taha

2011

Behavioral and Brain Functions

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“…The first stage corresponds to Kraepelin's staircase model of stepwise deterioration caused by psychotic episodes, as presumed in the questionable neurotoxicity hypothesis of psychosis recently revived (e.g. Wyatt 1991;Lieberman et al, 2001;2003). But this model is better replaced by another one, according to which the maximum of processes occur in the early illness course before remission of the first episode and is followed by a fairly stable phase without any clear-cut late improvement (Harrison et al, 1996;Wiersma et al, 2000).…”

Section: Long-term Social Coursementioning

confidence: 99%

“…Two groups of symptoms with significant age trends were an exception: paranoid and systematised delusions, which showed a significant linear increase, and incoherence of thought and disorders of self, which showed a significant linear decrease with age in both sexes. This age difference in the core symptoms of schizophrenia spectrum disorder is fragmentally reflected in numerous clinical descriptions of the disorder in different age groups Howard et al, 1994a, b;Almeida et al, 1995;Hafner & Nowotny, 1995;Hafner etal, 1998a;Hollis, 2003).…”

Section: Kraepelin's Thesismentioning

confidence: 99%

Schizophrenia: still Kraepelin's Dementia Praecox?

Häfner

2004

Epidemiol Psichiatr Soc

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SummaryAsking whether E. Kraepelin's early dementia praecox and disease concepts (1896) are still valid today, we condensed his early theory into four theses:1) schizophrenia is a disease entity, distinguishable from affective psychosis. 2) It is caused by a specific neuropathology. 3) It usually manifests itself in adolescence or early adulthood. 4) Underlying schizo- phrenia is a progressive disease process that leads to defects and dementia.Having tested whether Kraepelin's dementia praecox and modern schizophrenia are actually comparable, we studied 1) how schizophrenia and depression are linked or separable in terms of symptoms, risk factors and illness course from onset until five years after first treatment contact. The analyses are based on a population-based sample of 130 first admissions because of schiz- ophrenia, 130 age- and sex-matched first admissions because of unipolar depressive disorder and 130 “healthy” population con- trols from the study area. 2) Results will be presented that, though not very specific, confirm Kraepelin's farsighted hypothesis of a neuropathological basis of the disorder. In this context it will be discussed whether the brain changes are developmental or degenerative in origin. 3) The distribution of age of onset extends far into old age. In a sample of 1109 consecutive first admis- sions because of nonaffective psychosis from the total age range it was shown that age-dependent developmental factors mod- ify certain components of symptomatology linearly and significantly. The main risk factors, too, significantly change with age. 4) Long-term course was examined in three studies of epidemiologically recruited first-episode samples: Study 1 included five cross sections over 5 years, Study 2 was a prospective pre-post-comparison over 12 years supplemented by a retrospective assessment of the illness course (IRAOS) and Study 3 encompassed 10 cross sections over fifteen years. Finally, the disease concept of schizophrenia, as it presents itself in the light of current knowledge, will be outlined and compared with Kraepelin's earlier and later view of the disorder.Declaration of Interestthe paper is based on a lecture (Lettura magistrale) presented at the SIEP Sesto Congresso Nazionale, “Gli Esiti della Schizofrenia - Trattamenti, Pratica nei Servizi, Valutazione” in Sirmione, November 6-8, 2003. Unfortunately, the illustrations shown there and some 20 % of the relevant references could not be included in this printed ver- sion for lack of space. This paper was written within the framework of the German Research Network on Schizophrenia and was funded by the German Federal Ministry for Education and Research BMBF (grant 01GI 0236). The ABC study was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) as part of the Special Research Branch (Sonderforschungsbereich) 258 at the Central Institute of Mental Health until December 1998. From January 1999 to Sept. 2002 it was continued to be funded by the DFG.

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Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups

Zabala

Rapado

Arango

et al. 2009

Eur Arch Psychiatry Clin Neurosci

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The aims of this study were to examine the nature and extent of cognitive impairment in first-episode early-onset psychosis (FE-EOP) soon after their stabilisation and to search for potential differences according to specific diagnostic sub-groups of patients. As part of a Spanish multicentre longitudinal study, 107 FE-EOP patients and 98 healthy controls were assessed on the following cognitive domains: attention, working memory, executive functioning, and verbal learning and memory. Three diagnostic categories were established in the patient sample: schizophrenia (n = 36), bipolar disorder (n = 19), and other psychosis (n = 52). Patients performed significantly worse than controls in all cognitive domains. The three diagnostic sub-groups did not differ in terms of impaired/preserved cognitive functions or degree of impairment. FE-EOP patients show significant cognitive impairment that, during this early phase, seems to be non-specific to differential diagnosis.

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Child and Adolescent Onset Schizophrenia

Cited by 3 publications

References 146 publications

Long term functioning in early onset psychosis: Two years prospective follow-up study

Long term functioning in early onset psychosis: Two years prospective follow-up study

Schizophrenia: still Kraepelin's Dementia Praecox?

Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups

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