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Childhood and Adolescent Schizophrenic, Bipolar, and Schizoaffective Disorders: A Clinical and Outcome Study

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Abstract

Fity-nine child and adolescent psychotic patients (mean onset age 13.9, range 7–17, 83% 13 + years) had history and outcome studied using diagnses confimed at follow-up after 1 to 16 years (mean, 5 years), There were no differences in sex ratio, socioeconomic status, age of onset, and symptoms, but bipolar patients (N = 23) were often misdiagnosed as schizophrenic, had a better outcome, and a 50% homotypic family history. Schizophrenic subjects (N = 30) were more abnormal premorbidly, and only 17% were well at follow-up. Schizoaffective disorder was unreliable, infrequent, and more severe. Premorbid adjustment and IQ were the best predictors of outcome. Differences from the adult disorders were only quantitative. Careful follow-up of psychotic patients is needed to detect diagnostic errors.

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    Dr. Werry's research was supported by the Medical Research Council of New Zealand and Dr. McClellan's research was supported by the American Academy of Child and Adolescent Psychiatry. The assistance of Drs. M. Aimer, G. Finucane, M. Gudex, H. Clarkson, M. Taikato, R. Wyness in the collection of data and of Sarah Turbott in data analysis is gratefully acknowledged.

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