title: Two-year diagnostic stability in early-onset first-episode psychosis.
abstract: BACKGROUND
  Only one study has used a prospective method to analyze the diagnostic stability of first psychotic episodes in children and adolescents. The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a 2-year, prospective longitudinal study of early-onset first episodes of psychosis (EO-FEP).
  
  
  OBJECTIVE
  To describe diagnostic stability and the variables related to diagnostic changes.
  
  
  METHODS
  Participants were 83 patients (aged 9-17 years) with an EO-FEP consecutively attended. They were assessed with a structured interview (Kiddie-Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version) and clinical scales at baseline and after 2 years.
  
  
  RESULTS
  The global consistency for all diagnoses was 63.9%. The small group of bipolar disorder had high stability (92.31%) as did the group with schizophrenia spectrum disorders (90.00%). Depressive disorder had lower stability (37.50%) and the lowest values were for psychotic disorder not otherwise specified (11.76%) and brief psychotic disorder (0%).The most frequent diagnostic shift was to schizophrenia spectrum and bipolar disorders. One group of patients did not meet the criteria for any diagnosis at follow-up. Independent predictors of change to schizophrenia spectrum disorders were lower scores on the Children's Global Assessment Scale (CGAS) and the Hamilton Depression Rating Scale. Predictors of not having a diagnosis at follow-up were the CGAS and the Strauss-Carpenter Outcome Scale.
  
  
  CONCLUSIONS
  Global diagnostic stability was 63.9%. Bipolar and schizophrenia spectrum disorders were the most stable diagnoses, while depressive disorder and other psychosis the least stable. Psychosocial functioning at baseline was a good predictor of diagnosis at follow-up. These data show the need for longitudinal follow-up in EO-FEP before a stable diagnosis is reached.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona, Barcelona, Spain. jcastro@clinic.ub.es
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.forename: Immaculada
authors.initials: I
authors.lastname: Baeza
authors.forename: Elena
authors.initials: E
authors.lastname: de la Serna
authors.forename: Ana
authors.initials: A
authors.lastname: Gonzalez-Pinto
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.forename: Montserrat
authors.initials: M
authors.lastname: Graell
authors.forename: Dolores
authors.initials: D
authors.lastname: Moreno
authors.forename: Soraya
authors.initials: S
authors.lastname: Otero
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D013997:Time Factors