title: Comparing illness presentation, treatment and functioning between patients with adolescent- and adult-onset psychosis.
abstract: Studies have shown that early- and adult-onset schizophrenia patients differ in pre-morbid traits, illness presentation, psychopathology, and prognosis. We aimed to compare adult-onset patients (age range 26-55 years) with an adolescent-onset cohort (15-25 years) in demographics, illness presentation and functioning at baseline. Participants were from two territory-wide early intervention services for adolescent-onset (n=671) and adult-onset psychosis patients (n=360) in Hong Kong. The adolescent-onset cohort had their initial psychotic episode from 2001-2003; retrospective data collection was done through systematic case note review. The adult-onset cohort was recruited for a larger interventional study from 2009-2011; information was collected via face-to-face interviews. Adult-onset psychosis was significantly associated with more females, more smokers, more non-local birth, more full-time employment, better functioning, poorer medication adherence, more psychiatric hospitalization and fewer with schizophrenia than adolescent-onset psychosis (mean age: 20.4). The effect sizes were small, except for medication adherence where a robust effect was found. No group difference in DUP was found. The finding that adult-onset patients had better functioning challenges the view that adolescent- and adult-onset psychoses share a similar prognostic trajectory. Implications for adapting intervention processes for adolescent- and adult-onset psychosis are discussed.
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China. Electronic address: christy@lmhui.com.
authors.forename: Christy Lai-Ming
authors.initials: CL
authors.lastname: Hui
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Adrienne Wing-Yee
authors.initials: AW
authors.lastname: Li
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Chung-Ming
authors.initials: CM
authors.lastname: Leung
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wing-Chung
authors.initials: WC
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Sherry Kit-Wa
authors.initials: SK
authors.lastname: Chan
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Edwin Ho-Ming
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Eric Yu-Hai
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescent onset; Adult onset; Age of onset; First-episode; Schizophrenia