The psychosocial outcome of adolescent-onset schizophrenia: A 12-year followup

This study examines the educational/occupational outcome and social situati on of patients treated for schizophrenia in adolescence (age at admission 1 1.5-17.9 years; mean 16.0 years). Out of 96 consecutively admitted patients between 1976 and 1987, 85 (89%) could be traced and 65 (68%) were reassess ed more than 10 years after the first episode. At followup, 54 of the 65 (8 3%) had had at least one further inpatient-treated episode and 48 (74%) wer e receiving psychiatric treatment. Thirty-seven (57%) of the subjects were at least moderately impaired with respect to vocational functions (i.e., di d not achieve their premorbid educational/occupational goals). Serious soci al disability was found in 42 (66%) of the 64 subjects for whom social disa bility data were available. Regarding means of maintenance, 49 (75%) were f inancially dependent, supported by parents or public assistance. Impairment s were comparable for males and females. History of treatment (longer durat ion of inpatient stay; more than two inpatient episodes) was found to be pr edictive of lower vocational functioning at followup. Severity of positive symptoms and more than two inpatient episodes in the early course of illnes s predicted social disabilities in young adulthood. Findings support the vi ew that, because of early onset, the long-term perspective for many adolesc ent-onset schizophrenia patients is that of poor social adjustment, severe functional impairment, and high socioeconomic dependence and suggest that c onsequences are more severe than in adult-onset schizophrenia.