Basic symptoms, temperament and character in adolescent psychiatric disorders

Abstract

Objective: Basic symptoms are early subtle changes in thinking, feeling and perception that are subjectively experienced and precede the onset of a psychotic illness. In adult samples, high basic symptom scores are regarded as specific risk factors for the development of schizophrenia. The aim of this study was to explore the relevance of basic symptoms of psychiatric disorders in adolescent patients with special focus on early detection of psychosis. Furthermore, the association between basic symptoms and personality traits has been investigated.

Method: From 89 adolescents, who were consecutive inpatients with different psychiatric disorders in 1995 and 1997, 54 were followed up 4.7 years later. Patients were examined with the Bonn Scale for the Assessment of Basic Symptoms at the time of the first presentation and follow-up. Additionally, personality traits were assessed at follow-up using the Junior Temperament and Character Inventory.

Results: None of the subjects made the transition to schizophrenia, despite high baseline scores of basic symptoms at the initial assessment. Indirect minus symptoms were found to be the most valid predictor of a persisting psychiatric diagnosis. In addition, this specific category was strongly associated with the personality traits harm avoidance and self-directedness.

Conclusion: In adolescents, basic symptoms in association with personality traits present as a nonspecific indicator of psychopathology rather than as an indicator of vulnerability to schizophrenia.