A comparison of adolescent- and adult-onset first-episode, non-affective psychosis: 2-year follow-up
This study aimed to compare 2-year outcome among individuals with early-onset (EO; <18 years) versus adult-onset (AO) first-episode, non-affective psychosis. We compared clinical and treatment characteristics of 43 EO and 189 AO patients 2 years after their inclusion in a clinical epidemiologic population-based cohort study of first-episode psychosis. Outcome variables included symptom severity, remission status, drug abuse, treatment utilization, cognition and social functioning. At baseline, EO patients were more symptomatically compromised. However, these initial baseline differences were no longer significant at the 2-year follow-up. This study challenges the findings of a larger and older literature base consisting primarily of non-comparative studies concluding that teenage onset indicates a poor outcome. Our results indicate that adolescent-onset and adult-onset psychosis have similar prognostic trajectories, although both may predict a qualitatively different course from childhood-onset psychosis.
KeywordsFirst-episode psychosis Duration of untreated psychosis Adolescence Early-onset psychosis
The study was supported by the Norwegian National Research Council (#133897/320 and #154642/320), the Norwegian Department of Health and Social Affairs, and the National Council for Mental Health/Health and Rehabilitation (#1997/41 and #2002/306), Rogaland County and Oslo County (Drs. Vaglum, Johannessen, Friis, Larsen, Melle, Opjordsmoen). It was also funded by the Theodore and Vada Stanley Foundation, the Regional Health Research Foundation for Eastern Region, Denmark, Roskilde County, Helsefonden, Lundbeck Pharma, Eli Lilly and Janssen-Cilag Pharmaceuticals, Denmark (Dr. Haahr). The study was also supported by a National Alliance for Research on Schizophrenia and Depression (NARSAD) Distinguished Investigator Award, NIMH grant MH-01654 (Dr. McGlashan), NARSAD Young Investigator Award (Dr. Larsen) and Health West Trust (#200202797-65). The funding sources had no role in the design, analysis, interpretation and writing of the manuscript or in the decision to submit it for publication.
Conflict of interest
None of the authors report any conflict of interest.
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