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Forty-two-years later: the outcome of childhood-onset schizophrenia

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This paper describes the long-term course of 76 patients who had been consecutively admitted to the Department of Child and Adolescent Psychiatry, Philipps University, between 1920 and 1961 with a suspected diagnosis of childhood-onset schizophrenia. By means of a consensus analysis of available data in accordance with ICD-10 criteria, the diagnosis of schizophrenia was confirmed in only 50% of the original sample (n = 38, childhood-onset schizophrenia group); whereas the rest of the sample were allotted other diagnoses (n = 38, non-schizophrenia group). A follow-up investigation was conducted, interviewing all available patients, if possible, or their first-degree relatives or doctors. In the childhood-onset schizophrenia group, age at onset (mean ± S.D.) was 12.7 ± 2.5 (range 5–14) years and age at follow-up was 55.0 ± 4.8 (range 42–62) years. The outcome of this group was poor. According to the Global Assessment Scale (GAS), only 16% had a good (GAS score 71–100) and 24% had a moderate (GAS score 41–70) outcome. In the 16 childhood-onset schizophrenia patients who could be personally investigated at follow-up, 10 (62.5%) displayed severe or moderate depressive symptoms according to the BPRS depressive score. The death rate (including suicide) was significantly higher in the schizophrenia group (n = 15; 39.5%) than in the non-schizophrenia group (n = 7; 18.4%). A comparison of the life-time diagnoses of the total sample (n = 76) at follow-up with the ICD-10 diagnoses made retrospectively revealed a diagnostic stability in 69 (91%) and a change of diagnosis in 7 (9%) cases, among them 4 who were originally diagnosed as having childhood-onset schizophrenia.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Philipps-University Marburg, Marburg, Germany

    H. Remschmidt, M. Martin & F. M. Theisen

  2. Department of Child and Adolescent Psychiatry, Albert Ludwig-University Freiburg, Freiburg, Germany

    C. Fleischhaker, K. Hennighausen & E. Schulz

  3. Senior Statistician, Dade Behring GmbH, Marburg, Germany

    C. Gutenbrunner

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  1. H. Remschmidt
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  2. M. Martin
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  6. C. Gutenbrunner
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Remschmidt, H., Martin, M., Fleischhaker, C. et al. Forty-two-years later: the outcome of childhood-onset schizophrenia. J Neural Transm 114, 505–512 (2007). https://doi.org/10.1007/s00702-006-0553-z

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