Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis.
The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP.
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain. alreymejias@iisgm.com.
Ángel
Á
Del Rey-Mejías
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
David
D
Fraguas
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
Covadonga M
CM
Díaz-Caneja
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.|Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK.
Laura
L
Pina-Camacho
Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.|Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain.
Josefina
J
Castro-Fornieles
Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.|Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain.
Inmaculada
I
Baeza
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
Ana
A
Espliego
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
Jessica
J
Merchán-Naranjo
Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, Vitoria, Spain.
Ana
A
González-Pinto
Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain.|Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain.
Elena
E
de la Serna
Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain.
Beatriz
B
Payá
Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, CIBERSAM, Madrid, Spain.
Montserrat
M
Graell
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
Celso
C
Arango
Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain.
Mara
M
Parellada
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis*; D012559:Schizophrenia / Q000175:diagnosis*; D012917:Social Adjustment; D013997:Time Factors
Affective psychosis; Duration of untreated psychosis; Early-onset psychosis; First-episode psychosis; Global functioning; Premorbid adjustment; Schizophrenia