Early-Onset Schizophrenia1Remschmidt H. · Theisen F.
aDepartment of Child and Adolescent Psychiatry, Philipps University, Marburg, and bDepartment of Child and Adolescent Psychiatry, Herz-Jesu-Krankenhaus, Fulda, Germany
The available study findings on the course and outcome of schizophrenia beginning in childhood or adolescence can be summarized as follows. (1) Schizophrenic psychoses that arise before the age of 13 have a very poor prognosis. The disease usually continues to progress in adolescence and adulthood. It can be diagnosed with the same criteria that are used for adults. (2) Patients whose disease is of acute onset, with productive schizophrenic manifestations such as hallucinations and delusions (positive manifestations), have a better prognosis than those whose disease begins insidiously and takes an unfavorable course, with depressive states and continually worsening impairment of cognitive function. (3) The patient’s premorbid personality plays a major role. Patients who were described as socially active, intelligent, and integrated children and adolescents before they became ill have a better prognosis than those who were intellectually impaired, timid, introverted and uncommunicative before they became ill. (4) The prognosis seems to be better for patients who have no family history of schizophrenia, those whose families cooperate well, and those whose condition improves rapidly during inpatient treatment. (5) The few available studies on the course and outcome of schizophrenia beginning in childhood and early adolescence confirm that they are much worse than in adult-onset schizophrenia. (6) A 42-year longitudinal study of patients with childhood-onset schizophrenia revealed their suicide rate to be higher than that of patients with adult-onset schizophrenia. No further longitudinal studies are available to confirm this finding.
Prof. Helmut Remschmidt, MD, PhD
Department of Child and Adolescent Psychiatry, Philipps University
DE–35039 Marburg (Germany)
1 Translated from the original German by Ethan Taub.
Received: July 14, 2011
Accepted after revision: March 29, 2012
Published online: July 13, 2012
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 4, Number of References : 27
Neuropsychobiology (International Journal of Experimental and Clinical Research in Biological Psychiatry, Pharmacopsychiatry, Biological Psychology/Pharmacopsychology and Pharmacoelectroencephalography)
Vol. 66, No. 1, Year 2012 (Cover Date: July 2012)
Journal Editor: Strik W. (Bern)
ISSN: 0302-282X (Print), eISSN: 1423-0224 (Online)
For additional information: http://www.karger.com/NPS