Functional outcomes and patient satisfaction following inpatient treatment for childhood‐onset schizophrenia spectrum disorders vs non‐psychotic disorders in children in the United Kingdom

Abstract

Aim The aim of this study was to compare clinical characteristics and treatment outcomes between children with Childhood‐onset schizophrenia spectrum disorders (COSS) and children with other severe non‐psychotic psychiatric conditions (non‐COSS), all admitted to a national mental health inpatient children's unit. Methods We conducted a retrospective study of all children discharged from a national children's inpatient unit in the United Kingdom, between 2009 and 2018. We compared functional and treatment outcomes and satisfaction with treatment in COSS with non‐COSS in the whole sample and separately for male and female patients. Results A total of 211 children (55% boys) were included in the sample. The mean age on admission was 129.7 months (10.8 years; age range, 6‐12).Twenty cases were diagnosed with COSS (9.5%). In the whole sample, COSS patients had significantly lower Children's Global Assessment Scale (CGAS) scores on admission compared to non‐COSS (P = .006). There was a trend towards children with COSS as a group having a longer admission (M = 194.6 days, SD = 125.4) compared to non‐COSS (M = 135.8 days, SD = 86.2), (P = .053). Females with COSS seemed to have more significant differences compared to females with non‐COSS, in particular, longer admissions (P = .016) and worse CGAS scores at discharge (P = .04), whilst in males, these differences seemed to be attenuated. Conclusions Children with COSS have lower functioning at the point of inpatient admission and possibly longer admissions, but similar satisfaction with treatment at discharge from hospital compared with non‐COSS. Females with COSS may have worse functional outcomes compared to non‐COSS at discharge.

Clinical features and comorbidity in very early-onset schizophrenia: a systematic review

“…Galitzer et al ( 21 ), aimed to compare clinical characteristics and treatment outcomes of inpatients with Childhood-Onset Schizophrenia Spectrum Disorder (COSS) and those of others with a severe non-psychotic condition (non-COSS). The sample consisted of 20 individuals with a mean age at admission of 11 years, while there were 191 non-COSS patients, with a mean age at admission of 10.7.…”

“…However, these observations only partially align with evidence collected from VEOS samples. Males with VEOS consistently displayed an earlier onset of symptoms, while females tended to have poorer functional outcomes (as indicated by CGAS scores), longer periods of hospitalization, and greater use of medication ( 21 ). However, Ordonez et al reported no differences in clinical characteristics between sexes ( 24 ).…”

Debate: Feeling understood in a fake world – the place of inpatient mental health units in the care of children and adolescents

“…Inpatient mental health treatment has been associated with substantive sustained health gains across a range of diagnoses with longer stay being associated with better outcomes (Green et al, 2007). Specialist units which would allow longer admissions have been shown to be more beneficial that general units for children and young people with autism spectrum disorders (ASD; Taylor et al, 2019), whilst, in children, psychotic symptoms associated with ASD (Kyriakopoulos et al, 2015), psychotic disorders (Galitzer et al, 2021) and self-harm (Kipoulas, Berzengi, & Kyriakopoulos, 2020) may also require more time in hospital. Adolescents who have spent time in inpatient units have identified several benefits from their admission including feeling understood by other young people and staff, feeling stronger, and having made a step towards recovery (Gill, Butler, & Pistrang, 2016).…”