Association between nonpsychotic psychiatric diagnoses in adolescent males and subsequent onset of schizophrenia.
BACKGROUND
Nonpsychotic psychiatric symptoms may occasionally herald the later development of schizophrenia. This study followed a population-based cohort of adolescents with nonpsychotic, non-major affective psychiatric disorders to ascertain future hospitalization for schizophrenia.


METHODS
Results of the medical and mental health assessments on 124 24416- to 17-year-old males screened by the Israeli draft board were cross-linked with the National Psychiatric Hospitalization case registry, which contains data on all psychiatric hospitalizations in the country, during a 4- to 8-year-long follow-up through age 25 years. In the cohort, 9365 adolescents were assigned a nonpsychotic, non-major affective diagnosis by the draft board.


RESULTS
After excluding 167 adolescents who were hospitalized before or up to 1 year after the draft board assessment, 1.03% of the adolescents assigned a nonpsychotic, non-major affective psychiatric diagnosis, compared with only 0.23% of the adolescents without any psychiatric diagnosis, were later hospitalized for schizophrenia. Of the patients with schizophrenia, 26.8%, compared with only 7.4% in the general population, had been assigned a nonpsychotic, non-major affective psychiatric diagnosis in adolescence (overall odds ratio [OR], 4.5; 95% confidence interval [CI], 3.6-5.6), ranging from OR, 21.5 (95% CI, 12.6-36.6) for schizophrenia spectrum personality disorders to OR, 3.6 (95% CI, 2.1-6.2) for neurosis.


CONCLUSIONS
These results reflect the relatively common finding of impaired functioning in patients later hospitalized for schizophrenia and the relatively low power of these disorders in predicting schizophrenia.
Weiser
M
M
Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer 52621, Israel.
Reichenberg
A
A
Rabinowitz
J
J
Kaplan
Z
Z
Mark
M
M
Bodner
E
E
Nahon
D
D
Davidson
M
M
D000293:Adolescent; D015331:Cohort Studies; D016001:Confidence Intervals; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008889:Military Personnel / Q000706:statistics & numerical data; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D009497:Neurotic Disorders / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012737:Sex Factors