scholarly journals Developmental precursors of child- and adolescent-onset schizophrenia and affective psychoses: diagnostic specificity and continuity with symptom dimensions

2003 ◽  
Vol 182 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Chris Hollis
Keyword(s):  
Psychotic Symptom ◽  
Early Onset ◽  
Negative Symptoms ◽  
Child And Adolescent ◽  
Social Impairment ◽  
First Episode ◽  
Retrospective Case ◽  
Symptom Dimensions ◽  
Affective Psychoses ◽  
Developmental Continuity

BackgroundAn increased rate of premorbid impairment has been reported in both child- and adolescent-onset schizophrenic and affective psychoses.AimsTo examine the evidence for a specific association between premorbid impairment and child- and adolescent-onset schizophrenia, and whether specific continuities exist between premorbid impairments and psychotic symptom dimensions.MethodRetrospective case note study of 110 first-episode child- and adolescent-onset psychoses (age 10–17 years). DSM–III–R diagnoses derived from the OPCRIT algorithm showed 61 with schizophrenia (mean age 14.1 years) and 49 with other non-schizophrenic psychoses (mean age 14.7 years).ResultsPremorbid social impairment was more common in early-onset schizophrenia than in other early-onset psychoses (OR 1.9, P=0.03). Overall, impaired premorbid development, enuresis and incontinence during psychosis were specifically associated with the negative psychotic symptom dimension.ConclusionsPremorbid social impairments are more marked in child- and adolescent-onset schizophrenia than in other psychoses. There appears to be developmental continuity from premorbid impairment to negative symptoms.

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

scholarly journals S115. EVALUATION OF THE CLINICAL UTILITY OF SYMPTOM DIMENSIONS ON LONG-TERM CLINICAL AND FUNCTIONAL OUTCOMES IN FIRST EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S78-S78
Author(s):  
Ege Bor ◽  
Diego Quattrone ◽  
Victoria Rodriguez ◽  
Luis Alameda ◽  
Sinan Guloksuz ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Utility ◽  
Negative Symptoms ◽  
First Episode ◽  
Global Functioning ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Over Time

Abstract Background Current clinical utility of diagnostic categories in patients with psychosis is in debate. Alternatively, symptom-based dimensional approaches are suggested, but research on their utility and longitudinal stability is at its early phases, showing lack of consistencies. The aims of this prospective study are: 1) to test the stability of structure of symptom dimensions in first episode psychosis patients; 2) to explore the utility of symptom dimensions in predicting clinical and functional outcomes. Methods This study included a total of 208 with first episode of psychosis-spectrum disorders aged 18–65 years who presented to psychiatric services in South London, recruited as part of the Genetics and Psychosis Outcome (GAP) case-control study and EU-GEI multicentre case-control study. A subsample of 114 patients were traced after a mean of 6.5 years. Psychopathology was assessed at baseline and at follow-up using OPCRIT and tested with bifactor model, encompassing one general psychosis dimension and five specific symptom dimensions (positive, negative, disorganisation, mania, and depression). Follow up measures on functional outcome (assessed with GAF scale) and clinical outcomes (number and total length of hospitalisations) were derived from clinical records. Predictor role of baseline symptom dimensions was tested by multiple linear regression to predict global functioning; and by negative binomial regression for length of hospitalisation and number of hospital admissions. Results Factor loadings of disorganisation dimension were most likely to change longitudinally while loadings of positive dimension were most stable. Regarding dimension stability over time, all positive, disorganised and depressive symptoms significantly improved over time while manic and negative symptoms did not significantly differ. In terms of prediction of outcome, baseline manic symptoms were associated with reduced risk of hospitalisation (adj OR 1.56; 95% CI 1.01–2.38), reduced length of hospitalisation (adj IRR= 0.73; 95% CI 0.56–0.95) and better global functioning (β=5.21; 95% CI 2.46–7.95) at follow up. Similarly, depressive symptoms were associated with reduced length of hospitalisation (adj IRR= 0.77; CI 0.61–0.97). On the other hand, baseline positive symptoms were associated with increased risk of hospitalisation (adj OR 1.93; 95% CI 1.25–2.96). No other significant associations were found between the rest of symptom dimensions and outcomes. Discussion This study provides new evidence on the longitudinal stability of bifactor model of psychosis and, shows that all except manic and negative symptoms significantly improved over time. Whereas affective symptoms (including mania and depression) were associated with good prognosis, positive symptoms seem to predict poor clinical outcomes. The particular and different influence of affective and psychotic symptoms on long-term functional and clinical outcomes may have therapeutic implications and support the potential clinical utility of incorporating symptom-based approach in further outcome research.

Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses

2012 ◽  
Vol 43 (4) ◽  
pp. 757-768 ◽  
Author(s):  
I. Bombin ◽  
M. Mayoral ◽  
J. Castro-Fornieles ◽  
A. Gonzalez-Pinto ◽  
E. de la Serna ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Cognitive Development ◽  
Psychotic Symptom ◽  
Early Onset ◽  
Healthy Subjects ◽  
Psychotic Disorders ◽  
Brain Maturation ◽  
Psychotic Symptoms ◽  
First Episode

BackgroundThe longitudinal neuropsychological study of first-episode early-onset psychosis (EOP) patients, whose brain maturation is still in progress at the time of illness onset, provides a unique opportunity to compare their cognitive development with that of healthy subjects, in search of specific patterns resulting from the interaction between neurodevelopmental processes and the presence of psychotic disorders.MethodSeventy-five first-episode EOP patients (schizophrenia n = 35; bipolar disorder n = 17; other forms of psychosis n = 23) with a mean age of 15.53 years were assessed with a neuropsychological battery that included measures of attention, working memory, memory and executive functions within 6 months following the onset of the first psychotic symptom (baseline) and 2 years later. Psychotic symptoms were assessed at both times with the Positive and Negative Symptom Scale (PANSS). Seventy-nine healthy subjects matched for age and education served as controls.ResultsEOP patients showed significant cognitive impairment at both baseline and the 2-year follow-up, with no significant differences between diagnostic groups at either time. Both healthy controls and EOP patients improved in all cognitive measures, except for patient working memory. Improvement in patient attention lost significance after controlling for psychotic symptom reduction. No significant time/diagnosis interaction was found among patients (p > 0.405).ConclusionsCognitive impairment in EOP is already present at the first episode, and cognitive development seems to be arrested early in EOP patients compared to their healthy peers, at least for some cognitive functions. These and previous similar results support the neurodevelopmental hypothesis of psychosis.

Longitudinal assessment of negative symptoms in early onset first episode psychosis

2019 ◽  
Vol 29 ◽  
pp. S429-S430
Author(s):  
M. Garcia Traverso ◽  
D. Fraguas ◽  
C. Arango ◽  
J. Castro-Fornieles ◽  
A. González-Pinto ◽  
...  
Keyword(s):  
Early Onset ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Longitudinal Assessment ◽  
Episode Psychosis

Cannabis Use in a First Onset Psychosis Sample: Prevalence and Clinical Differences in Relation to Age of Onset

2017 ◽  
Vol 41 (S1) ◽  
pp. S275-S275
Author(s):  
M. Pardo ◽  
J. Matalí ◽  
A. Butjosa ◽  
V. Regina ◽  
M. Dolz ◽  
...  
Keyword(s):  
Early Onset ◽  
Age Of Onset ◽  
Pearson Correlation ◽  
Child And Adolescent ◽  
First Episode Psychosis ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis ◽  
Wide Range

IntroductionThere is a wide range of studies focusing on the use of cannabis in first episode psychosis (PEP). Literature using child and adolescent samples is scarce.Objectives and aimsTo determine the prevalence and clinical differences between cannabis users and non-cannabis users of early onset first episode psychosis (EOP), and adult onset first episode psychosis (AOP).MethodOne hundred and forty patients were recruited in adult (AOP subsample, n = 69) and child and adolescent (EOP subsample, n = 71) mental health services. The Positive and Negative Syndrome Scale was used for psychotic symptoms and the Calgary Scale for affective symptoms. The Chi2 test analysed clinical differences between users and nonusers within subsamples, and in the total sample a Pearson correlation was used for the relationship between age at cannabis use and PEP.ResultsThe prevalence of lifetime use of cannabis and the average age at first use were 48% and 13.82 years (± 1.15) in the EOP subsample, and 58% and 17.78 years (± 3.93) in the AOP subsample. Within EOP, cannabis users were older (P = .001), had fewer negative symptoms (P = .045) and less depressive symptoms (P = .005). Within AOP, cannabis users were younger (P = .018) and had greater severity of positive symptoms (P = .021). Age at first cannabis use and age at PEP were positively correlated.ConclusionsCannabis use is prevalent in adult and early onset psychosis. Cannabis users differ clinically from non-users, and the earlier the use of cannabis, the earlier the onset of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

FRONTAL CORTICAL THICKNESS IS ASSOCIATED WITH CLINICAL IMPROVEMENT OF NEGATIVE SYMPTOMS IN MALE ADOLESCENTS WITH EARLY-ONSET FIRST-EPISODE PSYCHOSIS

2010 ◽  
Vol 117 (2-3) ◽  
pp. 225-226
Author(s):  
Margarita Garcia-Amador ◽  
Jansen Joost ◽  
Santiago Reig ◽  
Mara Parellada ◽  
Dolores Moreno ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Cortical Thickness ◽  
Early Onset ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Male Adolescents ◽  
Episode Psychosis

scholarly journals The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis

2021 ◽  
Vol 10 (11) ◽  
pp. 2474
Author(s):  
Mariola Molina-García ◽  
David Fraguas ◽  
Ángel del Rey-Mejías ◽  
Gisela Mezquida ◽  
Ana Sánchez-Torres ◽  
...  
Keyword(s):  
Early Onset ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Clinical Severity ◽  
First Episode ◽  
Adult Onset ◽  
Recovery Rates ◽  
Functional Changes

Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. Results: early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). Conclusions: early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.

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