A 15-year comparative follow-up study of adolescent schizophrenia and acute and transient psychotic disorders with onset in adolescence

Abstract

Aim: Comparative follow-up studies on the course of adolescent schizophrenia, on the one hand, and syndromes diagnosed initially as acute and transient psychotic disorders in adolescence, on the other, are rare in the literature. In our analysis, we compared the course of these syndromes based on selected clinical and social indicators. Materials and methods: A total of 34 patients hospitalised in adolescence (time point 1) for schizophrenia (11 patients) and for acute and transient psychotic disorders (23 patients – both diagnoses according to the ICD-10 criteria) were re-examined 15 years later (time point 2). The assessment was based on a psychiatric examination as well as questionnaires, letters and queries in selected hospitals and psychiatric wards. Results: After 15 years, the respondents in the group with a baseline diagnosis of schizophrenia revealed a significantly higher severity of schizophrenia symptoms, particularly the axial symptoms of the illness, as well as a higher severity of cognitive deficits. They had more frequent and longer psychiatric hospitalisations during the follow-up period, with the difference being more pronounced in the sub-period of the first five years after hospitalisation. These subjects experienced a deeper regression at time point 2, with lower levels of insight and poorer working lives, and were significantly more likely to receive a diagnosis of schizophrenia than patients in the other group. Conclusions: A diagnosis of adolescent schizophrenia proves to be a more significant predictor of the patients’ deteriorated functioning both in terms of clinical and social parameters than a diagnosis of acute and transient psychotic disorders made during the same developmental period.