Pre-treatment, baseline, and outcome differences between early-onset and adult-onset psychosis in an epidemiological cohort of 636 first-episode patients.
OBJECTIVE
To assess pre-treatment, baseline, and outcome differences of patients with early- (onset<age 18) and adult-onset (onset>or=age 18) psychosis in an epidemiological cohort of first-episode patients.


METHODS
The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 786 FEP patients from January 1998 to December 2000. Data were collected from patients' files using a standardized questionnaire. Seven hundred four files were available, 61 of which were excluded owing to non-psychotic diagnoses or a psychotic disorder due to a general medical condition and 7 owing to missing data on age at onset. 636 patients were analyzed.


RESULTS
The mean age at onset was 21.3 years (SD 3.6); the prevalence of early-onset psychosis was 18.6% (onset range 8.2-17.9). Patients with early-onset were likely to have a slightly, but significantly worse premorbid functioning and a significantly longer duration of untreated psychosis (Median 26.3 weeks) compared to patients with adult-onset (Median 8.7 weeks; p<.001). After controlling for relevant confounders, no significant outcome differences including CGI-S, GAF, remission of positive symptoms, or employment status were detected between early- and adult-onset psychoses.


CONCLUSIONS
Patients with early-onset psychosis may require a different approach to early detection. Outcome differences between early- and adult-onset were minor, but need to be replicated in future (long-term) prospective epidemiological studies in other services.
Schimmelmann
Benno G
BG
Department of Child - and Adolescent Psychiatry and - Psychotherapy, University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany. bschimme@aol.com
Conus
Philippe
P
Cotton
Sue
S
McGorry
Patrick D
PD
Lambert
Martin
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001315:Australia / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D017064:Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D013997:Time Factors