Roepcke, B., & Eggers C., 2005. Early-onset schizophrenia: A 15-year follow-up . European Child and Adolescent Psychiatry, 14, 341-350.. request a copy

Introduction:
We describe the psychopathological and social outcome of patients treated for schizophrenia in adolescence with a mean onset age of 16.0 years (range 10.2-21.2 years).

Methods:
From 55 patients consecutively admitted to the clinic in Essen, 47 (85%) were traced and 39 (71%) could be re-examined. .

Results:
First: At follow-up 33/39 patients (85%) had had at least one re-admission.

Second: A full remission of global symptoms (a CGI rating of 2 or less) was found in 3 patients (8%), a moderate outcome (CGI 3.5) in 22 patients (56%) and a poor outcome was seen in 14 patients (36%).

Third: Severe to very severe impairments of global social function (GAS < 51) were observed in 10/39 patients (51%) .

Fourth: The best predictor of psychopathological and psychosocial outcome was the type of onset (CGI: beta=0.36; GAS: beta=-0.37). For those with an insidious, gradual onset, a poor outcome was seen in 22/24 cases.

Fifth: Together, all predictors explained 58% of the variance in the positive and negative syndrome (PANSS) ratings of negative symptoms at follow-up. ---- Gender, duration of first inpatient treatment and duration of untreated psychosis (DUP) had no value in the prediction of outcome.

Sixth: The nature of the diagnosis in the first episode strongly predicted diagnosis after the 15 year course - these were the same in 26/37 cases (70%)

Conclusions:
Our finding of an incidence of 61% insidious onset is similar to studies of schizophrenia with an adult onset (AOS), but differs from reports on very early onset schizophrenia (VEOS) - that show a higher rate of insidious onset, cognitive impairment and poor outcome. Thus, VEOS seems to represent a special group of patients with schizophrenia by comparison with the present early/adolescent onset group (EOS) and those with onset as adults (AOS).