Early-onset psychotic disorders: course and outcome over a 2-year period.
OBJECTIVE
To examine the course and outcome of early-onset psychotic disorders.


METHODS
These are data from a longitudinal, prospective study of youths with psychotic disorders. Standardized diagnostic and symptom rating measures were used.


RESULTS
Fifty-five subjects with the following disorders have been recruited: schizophrenia (n = 18), bipolar disorder (n = 15), psychosis not otherwise specified (n = 15), schizoaffective disorder (n = 6), and organic psychosis (n = 1). Follow-up assessments were obtained on 42 subjects at year 1 and 31 subjects at year 2. Youths with schizophrenia had more chronic global dysfunction, whereas subjects with bipolar disorder overall had better functioning, with a cyclical course of illness. However, according to results of a regression model, premorbid functioning and ratings of negative symptoms, but not diagnosis, significantly predicted the highest level of functioning over years 1 and 2.


CONCLUSIONS
Course and level of functioning differentiated bipolar disorder from schizophrenia. However, premorbid functioning and ratings of negative symptoms were the best predictors of functioning over the follow-up period. These findings are consistent with the adult literature, and they further support that psychotic illnesses in young people are continuous with the adult-onset forms.
McClellan
J
J
Department of Psychiatry, University of Washington, Seattle 98195, USA. drjack@u.washington.edu
McCurry
C
C
Snell
J
J
DuBose
A
A
D000293:Adolescent; D000294:Adolescent Behavior; D017668:Age of Onset; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000523:psychology*