A 45-year follow-up study of juvenile schizophrenia. Part III: Clinical picture and effect of the first hospitalization in the context of disease course and long-term social functioning of patients

Psychiatr Pol. 2022 Apr 30;56(2):229-244. doi: 10.12740/PP/125937. Epub 2022 Apr 30.
[Article in English, Polish]


Objectives: Research on predictors of adolescent schizophrenia, especially that based on long-term follow-up, is rare in the literature. In our analysis, we examine the relationship of the clinical picture and effect of the first hospitalization with clinical and social indicators of the disease.

Methods: A total of 69 patients at an 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).

Results: The clinical picture of the first episode of schizophrenia in terms of autism, apathy and abulia symptoms, splitting symptoms, formal thought disorders, catatonic symptoms, hebephrenic symptoms, delusions, hallucinations, and total severity of the schizophrenic psychopathology as a whole, as well as the effect of the first hospitalization (measured by the level of improvement, insight, and relational abilities), revealed numerous and various correlations with both the symptomatic picture and clinical course of schizophrenia and distant social functioning of the subjects. Variables of the greatest prognostic value were: initial autism and the level of clinical improvement, insight, and the ability to establish relationships, as measured at the end of the first hospitalization.

Conclusions: Negative symptoms during the first episode of schizophrenia and the quality of improvement in the areas of symptoms, insight, and the ability to establish relationships, achieved during the first hospital stay, turned out to be significant prognostic factors in juvenile schizophrenia.

Keywords: adolescence; prognosis; schizophrenia.

MeSH terms

  • Adolescent
  • Disease Progression
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Retrospective Studies
  • Schizophrenia* / diagnosis
  • Schizophrenia* / therapy
  • Schizophrenic Psychology
  • Social Interaction