Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland.
GfK Polonia, ul. Ludna 2, 00-406 Warsaw, Poland.
Compr Psychiatry. 2014 Jul;55(5):1174-81. doi: 10.1016/j.comppsych.2014.03.013. Epub 2014 Mar 31.
Despite inclusion of adolescent insanity-a concept proposed by Thomas Clouston in late XIX century-into the broader nosological entity of dementia praecox, the uniqueness of early psychosis is still discussed. The aim of the current study is the assessment of course and outcome in the large sample of early-onset psychosis subjects.
Of 299 patients hospitalized in the period 1998-2008 in an adolescent psychiatry ward with schizophrenia spectrum diagnosis 158 completed a follow-up interview. Data concerning current diagnosis, further admissions, current treatment status and occupational and relationship outcome were analyzed after a mean of 8 years of follow-up.
Mean age at the index admission and the follow-up was 16.6 ± 1.2 and 24.5 ± 3.0 years respectively. After the subsequent discharge almost all subjects (97%) at least briefly continued psychiatric treatment and 75% of patients had been readmitted. Overall diagnostic stability was 42%. For schizophrenia spectrum disorders and schizophrenia diagnostic stability was 72% and 78%, respectively. At the follow-up assessment 119 (77.3%) of the traced subjects declared current psychiatric treatment and 110 (73.3%) were receiving pharmacotherapy. Almost half of the subjects (48%) were employed or studying and more than a third (35.8%) remained in a stable relationship. Different distributions of baseline diagnoses were observed in males and females, and the latter showed a better outcome.
Early-onset psychoses were characterized by limited diagnostic stability, a necessity for further treatment and hospitalizations and significant percentage of unfavorable functional outcomes. Baseline diagnosis of acute and transient psychotic disorders and female gender were associated with an overall better outcome.
尽管托马斯·克劳斯顿（Thomas Clouston）在 19 世纪末提出的青少年精神错乱概念已被纳入更广泛的早发性痴呆分类实体中，但早期精神病的独特性仍在讨论中。本研究的目的是评估大量早发性精神病患者的病程和结局。
在 1998 年至 2008 年期间，在一个青少年精神病病房中，对 299 名被诊断为精神分裂症谱系障碍的患者进行住院治疗，其中 158 名患者完成了随访访谈。在平均 8 年的随访后，分析了当前诊断、进一步入院、当前治疗状况以及职业和关系结局的数据。
指数入院和随访时的平均年龄分别为 16.6 ± 1.2 岁和 24.5 ± 3.0 岁。随后出院后，几乎所有患者（97%）至少短暂地继续接受精神科治疗，75%的患者再次入院。总体诊断稳定性为 42%。对于精神分裂症谱系障碍和精神分裂症，诊断稳定性分别为 72%和 78%。在随访评估时，119 名（77.3%）被追踪的患者表示正在接受当前的精神科治疗，110 名（73.3%）正在接受药物治疗。近一半的患者（48%）有工作或学习，超过三分之一（35.8%）的患者保持稳定的关系。男性和女性的基线诊断分布不同，后者的结局更好。
早发性精神病的特点是诊断稳定性有限，需要进一步治疗和住院治疗，以及相当比例的不良功能结局。急性和短暂精神病障碍的基线诊断和女性性别与整体更好的结局相关。
