title: Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study.
abstract: OBJECTIVE
  The purpose of this study was to assess differences in the outcomes of youth with schizophrenia-spectrum disorders (SCZ-S) and psychotic disorder not otherwise specified (PsyNOS) during early antipsychotic treatment.
  
  
  METHODS
  The study was a prospective, naturalistic, inception cohort study of youth ≤19 years old with SCZ-S (schizophrenia, schizoaffective disorder, schizophreniform disorder) or PsyNOS (PsyNOS, brief psychotic disorder) and ≤24 months of lifetime antipsychotic treatment receiving clinician's choice antipsychotic treatment. Baseline demographic, illness and treatment variables, and effectiveness outcomes were compared at 12 weeks last-observation-carried-forward across SCZ-S and PsyNOS patients, adjusting for significantly different baseline variables.
  
  
  RESULTS
  Altogether, 130 youth with SCZ-S (n=42) or PsyNOS (n=88), mostly antipsychotic naïve (76.9%), were prescribed risperidone (47.7%), olanzapine (19.2%), aripiprazole (14.6%), quetiapine (11.5%), or ziprasidone (6.9%). Compared with those with PsyNOS, SCZ-S youth were older (16.4±2.1 vs. 14.8±3.2, p=0.0040), and less likely to be Caucasian (19.1% vs. 42.5%, p=0.009). At baseline, SCZ-S patients had significantly higher Clinical Global Impressions-Severity (CGI-S) scores (6.0±0.9 vs. 5.5±0.8, p=0.0018) and lower Children's Global Assessment Scale (CGAS) scores (29.6±9.2 vs. 36.1±8.9, p=0.0002) and were more likely to be in the severely ill CGAS group (i.e., CGAS≤40). SCZ-S and PsyNOS patients did not differ regarding all-cause discontinuation (40.5 vs. 40.3%. p=0.49), discontinuation because of adverse effects (12.2% vs. 12.4%, p=0.97), or nonadherence (29.3% vs. 30.9%, p=0.88), but somewhat more SCZ-S patients discontinued treatment for inefficacy (19.5% vs. 7.4%, p=0.063). CGI-S and CGAS scores improved significantly in both diagnostic groups (p=0.0001, each). Adjusting for baseline differences, PsyNOS patients experienced significantly better CGI-I improvement (CGI-I) scores (p=0.012) and more frequently reached higher categorical CGAS group status (p=0.021) than SCZ-S patients.
  
  
  CONCLUSIONS
  Both youth with SCZ-S and those with PsyNOS experienced significant improvements with clinician's choice antipsychotic treatment. However, treatment discontinuation was common within 12 weeks, with greater inefficacy-related discontinuation in the SCZ-S group, whereas CGI-I and CGAS score-based improvements were greater in the PsyNOS group.
authors.affiliation: 1 Research Unit for Child and Adolescent Psychiatry, Psychiatric Hospital, Aalborg University Hospital , Denmark .|2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Ditte L
authors.initials: DL
authors.lastname: Vernal
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kapoor
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Aseel
authors.initials: A
authors.lastname: Al-Jadiri
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Sheridan
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Yehonathan
authors.initials: Y
authors.lastname: Borenstein
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Charles
authors.initials: C
authors.lastname: Mormando
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: David
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Sukhbir
authors.initials: S
authors.lastname: Singh
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Seidman
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Maren
authors.initials: M
authors.lastname: Carbon
authors.affiliation: 3 University Clinics of Child and Adolescent Psychiatry, University of Zurich , Switzerland .
authors.forename: Miriam
authors.initials: M
authors.lastname: Gerstenberg
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.
authors.forename: Ema
authors.initials: E
authors.lastname: Saito
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.|4 Hofstra North Shore-LIJ School of Medicine , Hempstead, New York.|5 Albert Einstein College of Medicine , Bronx, New York.|6 The Feinstein Institute for Medical Research , Manhasset, New York.
authors.forename: John M
authors.initials: JM
authors.lastname: Kane
authors.affiliation: 1 Research Unit for Child and Adolescent Psychiatry, Psychiatric Hospital, Aalborg University Hospital , Denmark .|7 Clinical Psychology and Epidemiology, Department of Psychology, University of Basel , Switzerland .|8 Department of Child and Adolescent Psychiatry, University of Zurich , Switzerland .
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Steinhausen
authors.affiliation: 2 The Zucker Hillside Hospital , Psychiatry Research, North Shore-Long Island Jewish Health System, Glen Oaks, New York.|4 Hofstra North Shore-LIJ School of Medicine , Hempstead, New York.|5 Albert Einstein College of Medicine , Bronx, New York.|6 The Feinstein Institute for Medical Research , Manhasset, New York.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy*; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine