Skip to main content
SpringerLink
Log in

Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aas IH (2010) Global Assessment of Functioning (GAF): properties and frontier of current knowledge. Ann Gen Psychiatry 9:20

    Article  PubMed Central  PubMed  Google Scholar 

  2. Alvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, McGorry PD, Gleeson JF (2012) Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res 139:116–128

    Article  CAS  PubMed  Google Scholar 

  3. Amminger GP, Henry LP, Harrigan SM, Harris MG, Alvarez-Jimenez M, Herrman H, Jackson HJ, McGorry PD (2011) Outcome in early-onset schizophrenia revisited: findings from the early psychosis prevention and intervention centre long-term follow-up study. Schizophr Res 131:112–119

    Article  PubMed  Google Scholar 

  4. Andreasen NC, Pressler M, Nopoulos P, Miller D, Ho BC (2010) Antipsychotic dose equivalents and dose-years: a standardized method for comparing exposure to different drugs. Biol Psychiatry 67:255–262

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Arango C, Fraguas D, Parellada M (2014) Differential neurodevelopmental trajectories in patients with early-onset bipolar and schizophrenia disorders. Schizophr Bull 40(Suppl 2):S138–S146

    Article  PubMed Central  PubMed  Google Scholar 

  6. Asarnow JR, Tompson MC, Goldstein MJ (1994) Childhood-onset schizophrenia: a followup study. Schizophr Bull 20:599–617

    Article  CAS  PubMed  Google Scholar 

  7. Association AP (2000) Diagnostic And Statistical Manual Of Mental Disorders DSM-IV-TR Fourth Edition (Text Revision) Author: American Psychiatr

  8. Auther AM, McLaughlin D, Carrion RE, Nagachandran P, Correll CU, Cornblatt BA (2012) Prospective study of cannabis use in adolescents at clinical high risk for psychosis: impact on conversion to psychosis and functional outcome. Psychol Med 42:2485–2497

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Baldessarini RJ, Tondo L, Visioli C (2014) First-episode types in bipolar disorder: predictive associations with later illness. Acta Psychiatr Scand 129:383–392

    Article  CAS  PubMed  Google Scholar 

  10. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Ohlenschlaeger J, Le Quach P, Ostergaard Christensen T, Krarup G, Jorgensen P, Nordentoft M (2009) Course of illness in a sample of 265 patients with first-episode psychosis–five-year follow-up of the Danish OPUS trial. Schizophr Res 107:173–178

    Article  PubMed  Google Scholar 

  11. Bowie CR, Depp C, McGrath JA, Wolyniec P, Mausbach BT, Thornquist MH, Luke J, Patterson TL, Harvey PD, Pulver AE (2010) Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. Am J Psychiatry 167:1116–1124

    Article  PubMed Central  PubMed  Google Scholar 

  12. Cannon-Spoor HE, Potkin SG, Wyatt RJ (1982) Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 8:470–484

    Article  CAS  PubMed  Google Scholar 

  13. Carrion RE, McLaughlin D, Goldberg TE, Auther AM, Olsen RH, Olvet DM, Correll CU, Cornblatt BA (2013) Prediction of functional outcome in individuals at clinical high risk for psychosis. JAMA Psychiatry 70:1133–1142

    Article  PubMed Central  PubMed  Google Scholar 

  14. Castro-Fornieles J, Baeza I, de la Serna E, Gonzalez-Pinto A, Parellada M, Graell M, Moreno D, Otero S, Arango C (2011) Two-year diagnostic stability in early-onset first-episode psychosis. J Child Psychol Psychiatry 52:1089–1098

    Article  PubMed  Google Scholar 

  15. Castro-Fornieles J, Parellada M, Gonzalez-Pinto A, Moreno D, Graell M, Baeza I, Otero S, Soutullo CA, Crespo-Facorro B, Ruiz-Sancho A, Desco M, Rojas-Corrales O, Patino A, Carrasco-Marin E, Arango C, group C (2007) The child and adolescent first-episode psychosis study (CAFEPS): design and baseline results. Schizophr Res 91:226–237

    Article  PubMed  Google Scholar 

  16. Coentre R, Levy P, Figueira ML (2011) Early intervention in psychosis: first-episode psychosis and critical period. Acta Med Port 24:117–126

    PubMed  Google Scholar 

  17. Crumlish N, Whitty P, Clarke M, Browne S, Kamali M, Gervin M, McTigue O, Kinsella A, Waddington JL, Larkin C, O’Callaghan E (2009) Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis. Br J Psychiatry 194:18–24

    Article  PubMed  Google Scholar 

  18. Chang WC, Tang JY, Hui CL, Lam MM, Chan SK, Wong GH, Chiu CP, Chen EY (2012) Prediction of remission and recovery in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study. Aust N Z J Psychiatry 46:100–108

    Article  PubMed  Google Scholar 

  19. Fervaha G, Foussias G, Agid O, Remington G (2014) Motivational and neurocognitive deficits are central to the prediction of longitudinal functional outcome in schizophrenia. Acta Psychiatr Scand 130:290–299

    Article  CAS  PubMed  Google Scholar 

  20. First MB, Frances A, Pincus HA (2002) DSM-IV-TR handbook of differential diagnosis. American Psychiatric Publishing, Inc

  21. Fraguas D, de Castro MJ, Medina O, Parellada M, Moreno D, Graell M, Merchan-Naranjo J, Arango C (2008) Does diagnostic classification of early-onset psychosis change over follow-up? Child Psychiatry Hum Dev 39:137–145

    Article  PubMed  Google Scholar 

  22. Fraguas D, Del Rey-Mejias A, Moreno C, Castro-Fornieles J, Graell M, Otero S, Gonzalez-Pinto A, Moreno D, Baeza I, Martinez-Cengotitabengoa M, Arango C, Parellada M (2014) Duration of untreated psychosis predicts functional and clinical outcome in children and adolescents with first-episode psychosis: a 2-year longitudinal study. Schizophr Res 152:130–138

    Article  PubMed  Google Scholar 

  23. Fraguas D, Merchan-Naranjo J, Del Rey-Mejias A, Castro-Fornieles J, Gonzalez-Pinto A, Rapado-Castro M, Pina-Camacho L, Diaz-Caneja CM, Graell M, Otero S, Baeza I, Moreno C, Martinez-Cengotitabengoa M, Rodriguez-Toscano E, Arango C, Parellada M (2014) A longitudinal study on the relationship between duration of untreated psychosis and executive function in early-onset first-episode psychosis. Schizophr Res 158(1):126–133

    Article  PubMed  Google Scholar 

  24. Guy W (1976) ECDEU Assessment Manual for Psychopharmacology. US Department of Heath, Education, and Welfare Public Health Service Alcohol, Drug Abuse, and Mental Health Administration, Rockville

  25. Harrow M, Grossman LS, Herbener ES, Davies EW (2000) Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry 177:421–426

    Article  CAS  PubMed  Google Scholar 

  26. Henry LP, Amminger GP, Harris MG, Yuen HP, Harrigan SM, Prosser AL, Schwartz OS, Farrelly SE, Herrman H, Jackson HJ, McGorry PD (2010) The EPPIC follow-up study of first-episode psychosis: longer-term clinical and functional outcome 7 years after index admission. J Clin Psychiatry 71:716–728

    Article  PubMed  Google Scholar 

  27. Hoff AL, Svetina C, Shields G, Stewart J, DeLisi LE (2005) Ten year longitudinal study of neuropsychological functioning subsequent to a first episode of schizophrenia. Schizophr Res 78:27–34

    Article  PubMed  Google Scholar 

  28. Hollis C (2000) Adult outcomes of child- and adolescent-onset schizophrenia: diagnostic stability and predictive validity. Am J Psychiatry 157:1652–1659

    Article  CAS  PubMed  Google Scholar 

  29. Huber G (1997) The heterogeneous course of schizophrenia. Schizophr Res 28:177–185

    Article  CAS  PubMed  Google Scholar 

  30. Jeppesen P, Petersen L, Thorup A, Abel MB, Ohlenschlaeger J, Christensen TO, Krarup G, Jorgensen P, Nordentoft M (2008) The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis. Psychol Med 38:1157–1166

    Article  CAS  PubMed  Google Scholar 

  31. Jordan G, Lutgens D, Joober R, Lepage M, Iyer SN, Malla A (2014) The relative contribution of cognition and symptomatic remission to functional outcome following treatment of a first episode of psychosis. J Clin Psychiatry 75:e566–e572

    Article  PubMed  Google Scholar 

  32. Juola P, Miettunen J, Veijola J, Isohanni M, Jaaskelainen E (2013) Predictors of short- and long-term clinical outcome in schizophrenic psychosis–the Northern Finland 1966 Birth Cohort study. Eur Psychiatry 28:263–268

    Article  CAS  PubMed  Google Scholar 

  33. Juola P, Miettunen J, Veijola J, Isohanni M, Jaaskelainen E (2012) Predictors of short—and long-term clinical outcome in schizophrenic psychosis—the Northern Finland 1966 Birth Cohort study. Eur Psychiatry

  34. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988

    Article  CAS  PubMed  Google Scholar 

  35. Kuswanto CN, Sum MY, Sim K (2013) Neurocognitive functioning in schizophrenia and bipolar disorder: clarifying concepts of diagnostic dichotomy vs Continuum. Front Psychiatry 4:162

    Article  PubMed Central  PubMed  Google Scholar 

  36. Lewis SW, Owen MJ, Murray RM (1989) Obstetric complications and schizophrenia: methodology and mechanisms. In: Schulz SC, Tamminga CA (eds) Schizophrenia. A scientific focus. Oxford University Press, Oxford

    Google Scholar 

  37. Malla A, Norman R, Schmitz N, Manchanda R, Bechard-Evans L, Takhar J, Haricharan R (2006) Predictors of rate and time to remission in first-episode psychosis: a two-year outcome study. Psychol Med 36:649–658

    Article  PubMed  Google Scholar 

  38. Meier MH, Caspi A, Reichenberg A, Keefe RS, Fisher HL, Harrington H, Houts R, Poulton R, Moffitt TE (2014) Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. Am J Psychiatry 171:91–101

    Article  PubMed Central  PubMed  Google Scholar 

  39. Menezes NM, Malla AM, Norman RM, Archie S, Roy P, Zipursky RB (2009) A multi-site Canadian perspective: examining the functional outcome from first-episode psychosis. Acta Psychiatr Scand 120:138–146

    Article  CAS  PubMed  Google Scholar 

  40. Moller HJ, Jager M, Riedel M, Obermeier M, Strauss A, Bottlender R (2011) The Munich 15-year follow-up study (MUFUSSAD) on first-hospitalized patients with schizophrenic or affective disorders: assessing courses, types and time stability of diagnostic classification. Eur Psychiatry 26:231–243

    Article  CAS  PubMed  Google Scholar 

  41. Moorhead TW, McKirdy J, Sussmann JE, Hall J, Lawrie SM, Johnstone EC, McIntosh AM (2007) Progressive gray matter loss in patients with bipolar disorder. Biol Psychiatry 62:894–900

    Article  PubMed  Google Scholar 

  42. Morgan VA, Mitchell PB, Jablensky AV (2005) The epidemiology of bipolar disorder: sociodemographic, disability and service utilization data from the Australian National Study of Low Prevalence (Psychotic) Disorders. Bipolar Disord 7:326–337

    Article  PubMed  Google Scholar 

  43. Paya B, Rodriguez-Sanchez JM, Otero S, Munoz P, Castro-Fornieles J, Parellada M, Gonzalez-Pinto A, Soutullo C, Baeza I, Rapado-Castro M, Saenz-Herrero M, Moreno D, Arango C (2013) Premorbid impairments in early-onset psychosis: differences between patients with schizophrenia and bipolar disorder. Schizophr Res 146:103–110

    Article  PubMed  Google Scholar 

  44. Peralta V, Cuesta M (1994) Validación de la escala de los sindromes positivo y negativo (PANSS) en una muestra de esquizofrénicos españoles. Actas Luso Esp. Neurol. Psiquiatr 22:171–177

    Google Scholar 

  45. Pina-Camacho L, Garcia-Prieto J, Parellada M, Castro-Fornieles J, Gonzalez-Pinto AM, Bombin I, Graell M, Paya B, Rapado-Castro M, Janssen J, Baeza I, Pozo FD, Desco M, Arango C (2014) Predictors of schizophrenia spectrum disorders in early-onset first episodes of psychosis: a support vector machine model. Eur Child Adolesc Psychiatry

  46. Remberk B, Bazynska AK, Krempa-Kowalewska A, Rybakowski F (2014) Adolescent insanity revisited: course and outcome in early-onset schizophrenia spectrum psychoses in an 8-year follow-up study. Compr Psychiatry 55:1174–1181

    Article  PubMed  Google Scholar 

  47. Remschmidt H, Martin M, Fleischhaker C, Theisen FM, Hennighausen K, Gutenbrunner C, Schulz E (2007) Forty-two-years later: the outcome of childhood-onset schizophrenia. J Neural Transm 114:505–512

    Article  CAS  PubMed  Google Scholar 

  48. Rijcken CA, Monster TB, Brouwers JR, de Jong-van den Berg LT (2003) Chlorpromazine equivalents versus defined daily doses: how to compare antipsychotic drug doses? J Clin Psychopharmacol 23:657–659

    Article  CAS  PubMed  Google Scholar 

  49. Robertson DA, Hargreaves A, Kelleher EB, Morris D, Gill M, Corvin A, Donohoe G (2013) Social dysfunction in schizophrenia: an investigation of the GAF scale’s sensitivity to deficits in social cognition. Schizophr Res 146:363–365

    Article  PubMed  Google Scholar 

  50. Rodriguez-Sanchez JM, Ayesa-Arriola R, Perez-Iglesias R, Perianez JA, Martinez-Garcia O, Gomez-Ruiz E, Tabares-Seisdedos R, Crespo-Facorro B (2013) Course of cognitive deficits in first episode of non-affective psychosis: a 3-year follow-up study. Schizophr Res 150:121–128

    Article  PubMed  Google Scholar 

  51. Scott J, Leboyer M, Hickie I, Berk M, Kapczinski F, Frank E, Kupfer D, McGorry P (2013) Clinical staging in psychiatry: a cross-cutting model of diagnosis with heuristic and practical value. Br J Psychiatry 202:243–245

    Article  PubMed  Google Scholar 

  52. Schmael C, Georgi A, Krumm B, Buerger C, Deschner M, Nothen MM, Schulze TG, Rietschel M (2007) Premorbid adjustment in schizophrenia–an important aspect of phenotype definition. Schizophr Res 92:50–62

    Article  PubMed  Google Scholar 

  53. Schwartz RC (2007) Concurrent validity of the global assessment of functioning scale for clients with schizophrenia. Psychol Rep 100:571–574

    Article  PubMed  Google Scholar 

  54. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231

    Article  CAS  PubMed  Google Scholar 

  55. Silverstein ML, Mavrolefteros G, Close D (2002) Premorbid adjustment and neuropsychological performance in schizophrenia. Schizophr Bull 28:157–165

    Article  PubMed  Google Scholar 

  56. Spellmann I, Riedel M, Schennach R, Seemuller F, Obermeier M, Musil R, Jager M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkotter J, Heuser I, Maier W, Lemke MR, Ruther E, Klingberg S, Gastpar M, Moller HJ (2012) One-year functional outcomes of naturalistically treated patients with schizophrenia. Psychiatry Res 198:378–385

    Article  PubMed  Google Scholar 

  57. Strauss GP, Allen DN, Miski P, Buchanan RW, Kirkpatrick B, Carpenter WT Jr (2012) Differential patterns of premorbid social and academic deterioration in deficit and nondeficit schizophrenia. Schizophr Res 135:134–138

    Article  PubMed Central  PubMed  Google Scholar 

  58. Tarbox SI, Addington J, Cadenhead KS, Cannon TD, Cornblatt BA, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Heinssen R, McGlashan TH, Woods SW (2014) Functional development in clinical high risk youth: prediction of schizophrenia versus other psychotic disorders. Psychiatry Res 215:52–60

    Article  PubMed Central  PubMed  Google Scholar 

  59. Tarbox SI, Brown LH, Haas GL (2012) Diagnostic specificity of poor premorbid adjustment: comparison of schizophrenia, schizoaffective disorder, and mood disorder with psychotic features. Schizophr Res 141:91–97

    Article  PubMed Central  PubMed  Google Scholar 

  60. van Os J, Kapur S (2009) Schizophrenia. Lancet 374:635–645

    PubMed  Google Scholar 

  61. van Os J, Kenis G, Rutten BP (2010) The environment and schizophrenia. Nature 468:203–212

    Article  PubMed  Google Scholar 

  62. Verma S, Subramaniam M, Abdin E, Poon LY, Chong SA (2012) Symptomatic and functional remission in patients with first-episode psychosis. Acta Psychiatr Scand 126:282–289

    Article  CAS  PubMed  Google Scholar 

  63. Wechsler D (1997) Administration and Scoring Guide, WAIS-III, Wechsler Adult Intelligence Scale®—3rd edn(WAIS®–III). Psychological Corporation. In: Harcourt Brace and Company, San Antonio

  64. Wechsler D (1974) Wechsler intelligence scale for children-revised. Psychological Corporation

  65. Yung AR, McGorry PD (2007) Prediction of psychosis: setting the stage. Br J Psychiatry Suppl 51:s1–s8

    Article  PubMed  Google Scholar 

  66. Zipursky RB, Reilly TJ, Murray RM (2012) The myth of schizophrenia as a progressive brain disease. Schizophr Bull

Download references

Acknowledgments

Our work was supported by the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III (FIS PS09/01442 and PI12/1303), CIBERSAM, Madrid Regional Government (S2010/BMD-2422 AGES), European Union Structural Funds and European Union Seventh Framework Programme under grant agreements FP7-HEALTH-2009-2.2.1-2-241909 (Project EU-GEI), FP7-HEALTH-2009-2.2.1-3-242114 (Project OPTiMISE), FP7- HEALTH-2013-2.2.1-2-603196 (Project PSYSCAN) and FP7- HEALTH-2013-2.2.1-2-602478 (Project METSY); Fundación Alicia Koplowitz (FAK2012, FAK2013), Fundación Mutua Madrileña (FMM2009), and ERA-NET NEURON (Network of European Funding for Neuroscience Research) (PIM2010ERN-00642).

Conflict of Interest

Dr. Fraguas has been a consultant and/or advisor to or has received honoraria from Astra-Zeneca, Bristol-Myers-Squibb, Janssen, Lundbeck, Otsuka, and Pfizer. Dr. Díaz-Caneja has held a Río Hortega grant, Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness and a grant from Fundación Alicia Koplowitz. Dr. Pina-Camacho holds a grant from the Fundación Alicia Koplowitz and has previously held a Río Hortega grant, Instituto de Salud Carlos III, Spanish Ministry of Economy and Competiveness. Dr. Baeza has received honoraria from Otsuka. Dr. Ana González-Pinto has received grants and served as consultant, advisor, or CME speaker for the following entities: Almirall,  Astra-Zeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Glaxo-Smith-Kline, Janssen-Cilag, Jazz, Johnson & Johnson, Lundbeck, Merck, Otsuka, Pfizer, Sanofi-Aventis, Servier, Schering-Plough, Solvay, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, the Stanley Medical Research Institute, and Wyeth. Dr. Arango has been a consultant to or has received honoraria or grants from Abbot, AMGEN,  Astra-Zeneca, Bristol-Myers Squibb, Caja Navarra, CIBERSAM, Fundación Alicia Koplowitz, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Merck, Ministerio de Ciencia e Innovación, Ministerio de Sanidad, Ministerio de Economía y Competitividad, Mutua Madrileña, Otsuka, Pfizer, Roche, Servier, Shire, Takeda, and Schering-Plough. The rest of the authors report no conflicts of interest related to this work. There are no other published data or manuscripts based on these data pending a decision.

Author information

Authors and Affiliations

  1. Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Ibiza 43, 28009, Madrid, Spain

    Ángel Del Rey-Mejías, David Fraguas, Covadonga M. Díaz-Caneja, Laura Pina-Camacho, Ana Espliego, Jessica Merchán-Naranjo, Celso Arango & Mara Parellada

  2. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK

    Laura Pina-Camacho

  3. Department of Child and Adolescent Psychiatry and Psychology, SGR-489CIBERSAM. Institute Clinic of Neurosciences, IDIBAPS, Hospital Clinic of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles, Inmaculada Baeza & Elena de la Serna

  4. Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles, Inmaculada Baeza & Elena de la Serna

  5. Mood Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, CIBERSAM, Vitoria, Spain

    Ana González-Pinto

  6. Department of Child Psychiatry, Hospital Universitario Marqués de Valdecilla, CIBERSAM, Santander, Spain

    Beatriz Payá

  7. Section of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, CIBERSAM, Madrid, Spain

    Montserrat Graell

Authors
  1. Ángel Del Rey-Mejías
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Fraguas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Covadonga M. Díaz-Caneja
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura Pina-Camacho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Josefina Castro-Fornieles
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Inmaculada Baeza
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ana Espliego
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jessica Merchán-Naranjo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ana González-Pinto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Elena de la Serna
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Beatriz Payá
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Montserrat Graell
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Celso Arango
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Mara Parellada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ángel Del Rey-Mejías.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Del Rey-Mejías, Á., Fraguas, D., Díaz-Caneja, C.M. et al. Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis. Eur Child Adolesc Psychiatry 24, 1447–1459 (2015). https://doi.org/10.1007/s00787-015-0693-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-015-0693-5

Keywords

Search

Navigation