Difficulty in making contact with others and social withdrawal as early signs of psychosis in adolescents--the Northern Finland Birth Cohort 1986.
OBJECTIVE
Social withdrawal is among the first signs of the prodromal state of psychosis seen in clinical samples. The aim of this prospective study was to find out whether difficulty in making contact with others and social withdrawal precede first episode psychosis in the young general population.


METHODS
The members of the Northern Finland Birth Cohort 1986 (n=6274) completed the PROD-screen questionnaire in 2001-2002. The Finnish Hospital Discharge Register was used to detect both new psychotic and non-psychotic disorders requiring hospitalisation during 2003-2008.


RESULTS
Twenty-three subjects developed psychosis and 89 developed a non-psychotic mental disorder requiring hospitalisation during the follow-up. Of those who developed psychosis, 35% had reported difficulty or uncertainty in making contact with others and 30% social withdrawal in adolescence. In hospitalised non-psychotic disorder, the corresponding precentages were 10 and 13% and in the control group without hospital-treated mental disorder 9 and 11%. The differences between psychotic and non-psychotic hospitalised subjects (P<0.01) as well as controls (P<0.001) were statistically significant regarding difficulty or uncertainty in making contact with others.


CONCLUSIONS
In this general population-based sample self-reported difficulty or uncertainty in making contact with others in adolescence preceded psychosis specifically compared to hospitalised non-psychotic mental disorders and controls.
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland. Electronic address: pirjo.maki@oulu.fi.
P
P
Mäki
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
S
S
Koskela
Department of Psychiatry, University of Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom.
G K
GK
Murray
Institute of Health Sciences, University of Oulu, Oulu, Finland.
T
T
Nordström
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland.
J
J
Miettunen
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
E
E
Jääskeläinen
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland.
J M
JM
Veijola
D000293:Adolescent; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D062706:Prodromal Symptoms; D000297:Psychology, Adolescent; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012917:Social Adjustment; D012934:Social Isolation; D011795:Surveys and Questionnaires
Adolescent psychiatry; Epidemiology; Psychometry and assessments in psychiatry; Schizophrenia and psychosis; Social psychiatry