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

Abstract

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.

Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study

“…This finding was expected and is consistent with other studies in youth Helgeland and Torgersen 2005;Hassan and Taha 2011;Clemmensen et al 2012). For example, our results in the SCZ-S group are very comparable to the 8 week results from the Treatment of Early Onset Schizophrenia Spectrum Disorders (TEOSS) study, in which 44.0% were much or very much improved on the CGI-I (Sikich et al 2008), compared with 44.7% in our sample.…”

“…Therefore, future studies that include both SCZ-S and PsyNOS patients should present results for both subgroups. In the few child and adolescent studies with separate results for each diagnostic group or with a specific focus on PsyNOS, the sample size of the PsyNOS group was generally small Nicolson et al 2001;Correll et al 2005Fraguas et al 2008;Hassan and Taha 2011) with numbers of PsyNOS patients ranging between 6 and 26. To our knowledge, the present study is The analyses on decreased libido and impaired sexual performance are restricted to postpubertal patients.…”

“…The few small studies point to remission rates or CGAS-defined good outcome between 20% and 68% Nicolson et al 2001;Hassan and Taha 2011). As our co-primary outcome, we assessed categorical CGAS ratings, using the same cutoffs for good, moderate, and poor outcome as selected in a recent review on 21 studies in patients with early-onset schizophrenia and other psychotic disorders (Clemmensen et al 2012).…”

“…Early onset psychotic disorders are relatively rare, but usually quite severe (Rapado-Castro et al 2010), with research pointing to worse outcomes and prognosis for children and adolescents with psychotic disorders, especially schizophrenia, compared with adults (Clemmensen et al 2012). More children and adolescents present with adverse premorbid signs, such as neurocognitive deficits and poor social adjustment, as well as negative prognostic signs at onset, such as cognitive impairment, high level of negative symptoms, and insidious onset (Hassan and Taha 2011;Schimmelmann et al 2013b).…”

“…Relatively limited research is available on the epidemiology, clinical characteristics, and outcome of PsyNOS. Although many clinical studies include patients with PsyNOS (Wozniak et al 2008;Rapado-Castro et al 2010;Swadi et al 2010;Hassan and Taha 2011), studies rarely specify the outcome for different types of psychotic disorders, but either focus solely on schizophrenia or treat all psychotic disorders as one group. Moreover, trials just focusing on patients with Psy-NOS are lacking.…”