Short-term outcome of early-onset schizophrenia in a tertiary urban hospital

Background: Neurodevelopmental disorders, such as schizophrenia and other psychoses, usually show their first manifestations during childhood and adolescence, and 11%–18% of patients present with their first episode of psychosis before age 18. While adult-onset schizophrenia has been studied in great detail for many decades, research on early-onset schizophrenia (EOS) and very early-onset schizophrenia is still limited. Despite the interest in identifying outcome predictors in this population, studies are still scarce and have shown contradictory results. Aim: To study the outcome of EOS and the factors associated with it. Materials and Methods: This prospective, longitudinal hospital-based study was undertaken at the Psychiatry Department of Dr. D.Y. Patil Medical College Hospital and Research Center from September 2016 to September 2017. Patients diagnosed as having schizophrenia according to ICD–10 DCR and having an age less than 18 years were enrolled for the study after obtaining approval from the ethical committee. Thirty-one patients from outpatient and inpatient psychiatry departments were enrolled in the study. Information regarding sociodemographic details, illness, and treatment details was collected. Positive and Negative Syndrome Scale (PANSS) scores were collected each visit. The Clinical Global Impression (CGI) scale assessed treatment outcomes on follow-up visits. Results: The mean age of onset was 14.12 years. When assessed on the PANSS, predominant negative symptoms were noted in 13 (41.94%) patients and predominant positive symptoms in 18 (58.06%) patients. After treatment, significant improvement was seen in all the patients on the PANSS subscales. Furthermore, 35.48% had a positive family history of psychosis, while 38.71% gave a history of pre-episode stressors, and these factors adversely affected the outcome. Gender did not affect the outcome. Another noteworthy finding was the presence of some sexual abuse in 22.58% of the cases. Conclusion: The outcome of EOS is affected by several factors such as age of onset, nature of symptoms, family history, and pre-episodic stressors. Detailed history is of utmost importance in the management of psychosis of early onset.