Journal Article

Long-Term Course of Adolescent Schizophrenia

Christian Fleischhaker, Eberhard Schulz, Kathrin Tepper, Matthias Martin, Klaus Hennighausen and Helmut Remschmidt

in Schizophrenia Bulletin

Published on behalf of Maryland Psychiatric Research Center

Volume 31, issue 3, pages 769-780
Published in print January 2005 | ISSN: 0586-7614
Published online January 2005 | e-ISSN: 1745-1701 | DOI: http://dx.doi.org/10.1093/schbul/sbi014
Long-Term Course of Adolescent Schizophrenia

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Our study investigated premorbid functioning, course, and outcome in early-onset schizophrenia. All inpatients with DSM–III–R diagnoses of schizophrenia (n = 101) consecutively admitted between 1983 and 1988 to the Department of Child and Adolescent Psychiatry at the University of Marburg in Germany were included. To assess premorbid adaptation and precursor symptoms, we administered the Instrument for the Retrospective Assessment of the Onset of Schizophrenia, which we modified to assess children and adolescents. Symptomatology was measured by the Scale for the Assessment of Negative Symptoms, the Scale for the Assessment of Positive Symptoms, and the Brief Psychiatric Rating Scale. In addition, the Global Assessment of Functioning was applied. Followup data for 81 patients (80.2%) were available. The mean duration of schizophrenia at followup was 9.5 ± 2.2 years. Assessment of the highest level of adaptive functioning revealed very good or good outcome in 19.8 percent of the patients, fair or poor outcome in 38.2 percent, and very poor outcome and gross impairment in 42.0 percent. Premorbid adjustment was the best predictor of outcome in our schizophrenia sample. A poor prognosis was found in patients with premorbid developmental delays and those who were introverted and withdrawn before their psychotic state.

Keywords: Early-onset schizophrenia; course; outcome; premorbid development

Journal Article.  6131 words.  Illustrated.

Subjects: Child and Adolescent Psychiatry

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