title: Adolescent insanity revisited: course and outcome in early-onset schizophrenia spectrum psychoses in an 8-year follow-up study.
abstract: OBJECTIVE
  Despite inclusion of adolescent insanity-a concept proposed by Thomas Clouston in late XIX century-into the broader nosological entity of dementia praecox, the uniqueness of early psychosis is still discussed. The aim of the current study is the assessment of course and outcome in the large sample of early-onset psychosis subjects.
  
  
  METHODS
  Of 299 patients hospitalized in the period 1998-2008 in an adolescent psychiatry ward with schizophrenia spectrum diagnosis 158 completed a follow-up interview. Data concerning current diagnosis, further admissions, current treatment status and occupational and relationship outcome were analyzed after a mean of 8 years of follow-up.
  
  
  RESULTS
  Mean age at the index admission and the follow-up was 16.6 ± 1.2 and 24.5 ± 3.0 years respectively. After the subsequent discharge almost all subjects (97%) at least briefly continued psychiatric treatment and 75% of patients had been readmitted. Overall diagnostic stability was 42%. For schizophrenia spectrum disorders and schizophrenia diagnostic stability was 72% and 78%, respectively. At the follow-up assessment 119 (77.3%) of the traced subjects declared current psychiatric treatment and 110 (73.3%) were receiving pharmacotherapy. Almost half of the subjects (48%) were employed or studying and more than a third (35.8%) remained in a stable relationship. Different distributions of baseline diagnoses were observed in males and females, and the latter showed a better outcome.
  
  
  CONCLUSIONS
  Early-onset psychoses were characterized by limited diagnostic stability, a necessity for further treatment and hospitalizations and significant percentage of unfavorable functional outcomes. Baseline diagnosis of acute and transient psychotic disorders and female gender were associated with an overall better outcome.
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland. Electronic address: bremberk@ipin.edu.pl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Remberk
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland. Electronic address: abazynska@ipin.edu.pl.
authors.forename: Anna Katarzyna
authors.initials: AK
authors.lastname: Bażyńska
authors.affiliation: GfK Polonia, ul. Ludna 2, 00-406 Warsaw, Poland. Electronic address: anna.krempa-kowalewska@gfk.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Krempa-Kowalewska
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, ul. Sobieskiego 9, 02-957 Warsaw, Poland; University of Social Sciences and Humanities, ul. Kutrzeby 10, Poznan, Poland. Electronic address: filrybak@yahoo.com.
authors.forename: Filip
authors.initials: F
authors.lastname: Rybakowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult