title: The Relative Importance of Family History, Gender, Mode of Onset, and Age at Onsetin Predicting Clinical Features of First-Episode Psychotic Disorders.
abstract: OBJECTIVE
  Family history of psychosis, gender, mode of onset, and age at onset are considered prognostic factors important to clinicians evaluating first-episode psychosis; yet, clinicians have little guidance as to how these four factors differentially predict early-course substance abuse, symptomatology, and functioning. We conducted a "head-to-head comparison" of these four factors regarding their associations with key clinical features at initial hospitalization. We also assessed potential interactions between gender and family history with regard to age at onset of psychosis and symptom severity.
  
  
  METHODS
  Consecutively admitted first-episode patients (n=334) were evaluated in two studies that rigorously assessed a number of early-course variables. Associations among variables of interest were examined using Pearson correlations, χ2tests, Student's t-tests, and 2×2 factorial analyses of variance.
  
  
  RESULTS
  Substance (nicotine, alcohol, and cannabis) abuse and positive symptom severity were predicted only by male gender. Negative symptom severity and global functioning impairments were predicted by earlier age at onset of psychosis. General psychopathology symptom severity was predicted by both mode of onset and age at onset. Interaction effects were not observed with regard to gender and family history in predicting age at onset or symptom severity.
  
  
  CONCLUSIONS
  The four prognostic features have differential associations with substance abuse, domains of symptom severity, and global functioning. Gender and age at onset of psychosis appear to be more predictive of clinical features at the time of initial evaluation (and thus presumably longer term outcomes) than the presence of a family history of psychosis and a more gradual mode of onset.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Compton
authors.forename: Chantal
authors.initials: C
authors.lastname: Berez
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D055815:Young Adult
keywords: Age at Onset; Family History; First-Episode Psychosis; Mode of Onset; Psychosis; Schizophrenia