Clinical Presentations of Early-Onset Schizophrenia: A 10-Year Retrospective Chart Review

Objective: To collect and describe the clinical presentations of early-onset schizophrenia in a clinical setting. In addition, the authors aimed to compare the clinical presentations of early-onset schizophrenia (EOS) and very early-onset schizophrenia (VEOS). Materials and Methods: A 10-year retrospective chart review of early-onset schizophrenia participants, both inpatients and outpatients, who received psychiatric treatments at Ramathibodi Hospital, Bangkok, Thailand between January 2011 and December 2020. Subjects were divided into two groups by age of onset symptoms, 1) EOS with onset between 13- to 18-years-old, and 2) VEOS with onset before 13-years-old. Descriptive statistics in term of frequency and percentage were used to describe clinical characteristics. Regarding the comparisons between groups, the differences were considered as statistically significant at the level of a p-value of less than 0.05. Results: Forty-one participants were analyzed. The VEOS subgroup included nine participants (22%) and EOS subgroup included 32 participants (78%). The age of symptom onset ranged from 7.9 to 17.7 years old, with a mean of 14.2 years old (SD 2.5 years). The diagnostic stability was 82.9%. Thirty-seven (90.2%) and 39 participants (95.1%) demonstrated delusion and auditory hallucination, respectively. Only 13 participants (31.7%) reported visual hallucination. Moreover, there were statistically significant differences between EOS and VEOS on gender, other psychiatric comorbidities apart from depressive disorders, and the number of other psychotropic medication classes apart from antipsychotic medications. The female predominance demonstrated in VEOS subgroup, while the male predominance was found in EOS subgroup. Conclusion: Although EOS was rare, the diagnostic stability of EOS was high. Auditory hallucination was the most common psychotic presentation reported in this population. The female predominance was demonstrated in the VEOS subgroup, while the male predominance was found in the EOS subgroup. Keywords: Early-onset schizophrenia; Childhood; Adolescence; Clinical presentations