J Korean Acad Child Adolesc Psychiatry.  2017 Apr;28(2):132-140. 10.5765/jkacap.2017.28.2.132.

Demographic Characteristics, Medication Profile and Treatment Outcome of Patients with Very Early-Onset Schizophrenia in One Hospital

• Choi S
• Cho HK
• Lee MK

• KMID: 2377222
• DOI: http://doi.org/10.5765/jkacap.2017.28.2.132

Abstract

OBJECTIVES
Very early-onset schizophrenia (VEOS) is a type of psychosis having a low frequency, insidious onset, and devastating clinical outcome. In this study, the demographic features, information on medication, clinical outcomes, and intellectual capability of patients diagnosed with VEOS in a hospital were analyzed to provide therapeutic strategies for this type of schizophrenia.
METHODS
Using the electronic medical records of the National Center for Mental Health, 69 patients with VEOS were identified based on the DSM-5 criteria of schizophrenia. The data were summarized and analyzed according to the demographic characteristics, medications used, intellectual strength measured by the full intelligence quotient (FIQ) score, and current clinical status measured by the Clinical Global Impression-Severity (CGI-S) and various combinations of these parameters.
RESULTS
The screened study group contained similar numbers of males and females. The younger the onset of psychosis, the lower the frequency. The study population included a significantly higher proportion of births in the winter season than that of the general population. The 3 most frequently used antipsychotic medications were risperidone and its derivatives, clozapine and olanzapine. Valproic acid and divalproex sodium were the most commonly added drugs for outcome augmentation. 53.5% of the study population had received benzodiazepines and/or hypnotics. The average FIQ of the study population was 69.4, which is quite low compared to previous Korean studies with similar populations. There was a weak negative correlation between FIQ and CGI-S, but it was not statistically significant. The average CGI-S score was 4.2, which meant that the patients were moderately ill.
CONCLUSION
This study demonstrated that patients with VEOS showed more frequent intellectual deficits at baseline and poorer outcomes than the control group. Risperidone, clozapine, valproic acid and their combinations were the most preferred medications for the treatment of psychosis. Benzodiazepines were quite commonly added for various reasons.

Keyword

Very early-onset schizophrenia; Outcome; Antipsychotics; Intelligence; Benzodiazepine

MeSH Terms

Antipsychotic Agents
Benzodiazepines
Clozapine
Electronic Health Records
Female
Humans
Hypnotics and Sedatives
Intelligence
Male
Mental Health
Parturition
Psychotic Disorders
Risperidone
Schizophrenia*
Seasons
Treatment Outcome*
Valproic Acid
Antipsychotic Agents
Benzodiazepines
Clozapine
Hypnotics and Sedatives
Risperidone
Valproic Acid