Six-year outcomes in first admission adolescent inpatients: clinical and cognitive characteristics at admission as predictors.
Persistent functional disability is common after even a single psychiatric admission in people with schizophrenia or bipolar disorder, but less is known about other conditions and about adolescent onset patients. This study examined clinical symptoms and cognitive performance at the time of the first admission for the prediction of 6-year outcomes. First admission adolescent patients with a variety of psychiatric diagnoses were assessed with comprehensive clinical ratings of psychopathology, a neuropsychological assessment, and received clinical diagnoses while experiencing their first psychiatric admission. They were contacted 6 years after discharge and examined with a structured assessment of psychiatric symptoms and functioning. Despite the low levels of overall impairment at follow-up, at least 20% of the variance in depression, psychosis, poor peer relationships and poor school attendance 6 years after the hospital admission were predicted by information collected during the hospitalization. Attentional deficits during admission predicted the presence of psychosis at follow-up more substantially than psychotic symptoms during admission, as well as predicting risk for relapse. Attentional deficits during a first psychiatric admission predicted risk for manifesting psychosis at 6-year follow-up to a more substantial degree than either a psychosis diagnosis or psychotic symptoms at admission. In contrast to psychosis, depression at follow-up was predicted by admission symptomatology, but not by cognitive deficits.
Department of Psychological Assessment, Four Winds Hospital, Katonah, NY, USA.
David L
DL
Pogge
Brie
B
Insalaco
Hilary
H
Bertisch
Lale
L
Bilginer
John
J
Stokes
Barbara A
BA
Cornblatt
Philip D
PD
Harvey
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D009483:Neuropsychological Tests; D010359:Patient Readmission; D010379:Peer Group; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012917:Social Adjustment