A 45-year follow-up study of adolescent schizophrenia. Part IV: Clinical status and level of social adaptation 5 years after the first hospitalization in the context of illness course and long-term social functioning of patients.

Mariusz Ślosarczyk,Katarzyna Ślosarczyk,Mariusz Furgał

doi:10.12740/pp/onlinefirst/125744

Abstract

Research on predictors of adolescent schizophrenia, especially those based on long-term follow-up studies, is rare in the literature. In our analysis, we examine the relationship of the clinical status and level of social adaptation 5 years after the first hospitalization with clinical and social indicators of the illness course. 69 patients at the average age of 16 years (time point 0), hospitalized due to schizophrenia (retrospectively re-diagnosed according to ICD-10 criteria) and re-examined 5 years later (time point 1 - personal examination of 41 individuals), were re-evaluated for clinical and social parameters 45 years after their initial hospitalization (time point 2 - personal examination of 21 individuals). In addition to the personal survey, other methods of data collection were used, including hospital queries. The clinical picture of schizophrenia 5 years after the first hospitalization described by the severity of psychopathology, as well as other parameters of the clinical status (e.g., insight, clinical improvement, relational abilities, GAF), revealed numerous and various correlations both with the symptomatic picture and clinical course of schizophrenia 45 years after the first hospitalization as well as with distant social functioning of the subjects. In the analyses, high prognostic significance was also revealed by the level of psychotic relapse, the presence of auto-aggressive tendencies, and the quality of school and professional adaptation assessed at time point 1. he level of functioning achieved by the patient in clinical and social areas during the first 5 years after their initial hospitalization proved to be an important prognostic factor in adolescent schizophrenia.

Highlights

Notes outlining the general theoretical context of the research project are included in the introduction to Part I of the cycle [1]
The clinical picture of schizophrenia 5 years after the first hospitalization described by the severity of psychopathology, as well as other parameters of the clinical status, revealed numerous and various correlations both with the symptomatic picture and clinical course of schizophrenia 45 years after the first hospitalization as well as with distant social functioning of the subjects
High prognostic significance was revealed by the level of psychotic relapse, the presence of auto-aggressive tendencies, and the quality of school and professional adaptation assessed at time point 1

Summary

Introduction

Notes outlining the general theoretical context of the research project are included in the introduction to Part I of the cycle [1]. It is quite commonly accepted that the first couple of years of the development of the disorder are crucial for its later course and distant prognosis [2] During this period, the dynamics of this development seems to be the highest, sometimes resulting in early deterioration difficult to fully reverse at a later time point [3]. The dynamics of this development seems to be the highest, sometimes resulting in early deterioration difficult to fully reverse at a later time point [3] Many such findings are based on adult patient studies, they are confirmed by follow-up studies encompassing the EOS (early onset schizophrenia) population [4,5,6]. It is known that previous educational achievements [8, 9] and professional experience [9,10,11] correlate favorably with the subsequent professional functioning of patients, firstly, the quoted studies refer to schizophrenia as a whole and not to adolescent schizophrenia or EOS, and secondly, they are not of follow-up nature

Methods

Results

Discussion

Conclusion