Association between nonpsychotic psychiatric diagnoses in adolescent malesand subsequent onset of schizophrenia

Background: Nonpsychotic psychiatric symptoms may occasionally herald the l ater development of schizophrenia. This study followed a population-based c ohort of adolescents with nonpsychotic, non-major affective psychiatric dis orders to ascertain future hospitalization for schizophrenia. Methods: Results of the medical and mental health assessments on 124 244 16 - to 17-year-old males screened by the Israeli draft board were cross-linke d with the National Psychiatric Hospitalization case registry, which contai ns data on all psychiatric hospitalizations in the country during a 4- to 8 -year-long follow-up through age 25 years. In the cohort, 9365 adolescents were assigned a nonpsychotic, non-major affective diagnosis by the draft bo ard. Results: After excluding 167 adolescents who were hospitalized before or up to 1 year after the draft board asassessment, 1.03% of the adolescents ass igned a nonpsychotic, non-major affective psychiatric diagnosis, compared w ith only 0.23% of the adolescents without any psychiatric diagnosis, were l ater hospitalized for schizophrenia. Of the patients with schizophrenia, 26 .8%, compared with only 7.4% in the general population, had been assigned a nonpsychotic, non-major affective psychiatric diagnosis in adolescence (ov erall odds ratio [OR], 4.5; 95% confidence interval [CI], 3.6-5.6), ranging from OR, 21.5 (95% CI, 12.6-36.6) for schizophrenia spectrum personality d isorders to OR, 3.6 (95% CI, 2.1-6.2) for neurosis. Conclusion: These results reflect the relatively common finding of impaired functioning in patients later hospitalized for schizophrenia and the relat ively low power of these disorders in predicting schizophrenia.