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Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?

Published online by Cambridge University Press:  23 March 2020

P. Golay ,
L. Alameda ,
N. Mebdouhi ,
P. Baumann ,
C. Ferrari ,
A. Solida ,
P. Progin ,
J. Elowe  and
P. Conus
P. Golay*
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland Service of Community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
L. Alameda
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), 1008Lausanne, Switzerland Psychiatric Liaison Service, Lausanne University Hospital (CHUV), 1011Lausanne, Switzerland
N. Mebdouhi
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
P. Baumann
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), 1008Lausanne, Switzerland
C. Ferrari
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
A. Solida
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
P. Progin
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
J. Elowe
Affiliation:
Mobile Psychiatry Unit, Department of Psychiatry, Prangins Psychiatric Hospital (CHUV), 1197Prangins, Switzerland
P. Conus
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), 1003Lausanne, Switzerland
*
*Corresponding author. Department of Psychiatry, Lausanne University Hospital, consultations de Chauderon, 18, place Chauderon, 1003 Lausanne, Switzerland. Fax: +41 213 141 277. E-mail address:philippe.golay@chuv.ch (P. Golay).
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Abstract

Background:

While there is suggestion that early onset of psychosis is a determinant of outcome; knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients.

Methods:

Two hundred and fifty-six early psychosis patients aged 18–35 were followed-up prospectively over 36 months. Patients with onset after 26 (“later onset”, LO) were compared to the rest of the sample.

Results:

LO patients (32% of the sample) had shorter DUP, were less likely to be male, had better premorbid functioning and were more likely to have been exposed to trauma. They had greater insight at presentation and less negative symptoms overall. The trajectories for positive and depressive symptoms were similar in both groups. Evolution of functional level was similar in both groups, but while LO patients recovered faster, they were significantly less likely to return to premorbid functional level.

Conclusions:

Later psychosis onset correlates with better premorbid functioning and higher rate of trauma exposure; the latter should therefore be a treatment focus in such patients. LO patients were less likely to return to premorbid functional level, which suggests that current treatment strategies may not be efficient to help patients maintain employment. The possibility of distinct illness mechanisms according to onset age and the more central role for trauma in patients with onset after age 26 needs to be further explored.

Keywords

Age of onsetEarly psychosisEarly interventionTrauma
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 20 - 26
Copyright
Copyright © European Psychiatric Association 2017

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References

De Haan, LBakker, JOverview of neuropathological theories of schizophrenia: from degeneration to progressive developmental disorder. Psychopathology 2004;37(1):1–7.CrossRefGoogle ScholarPubMed
Eggers, CSome remarks on etiological aspects of early-onset schizophrenia. Eur Child Adolesc Psychiatry 1999;8(1):S1–S4.CrossRefGoogle ScholarPubMed
Poustka, LParzer, PBrunner, RResch, FBasic symptoms, temperament and character in adolescent psychiatric disorders. Psychopathology 2007;40(5):321–328.CrossRefGoogle ScholarPubMed
Bland, RCParker, JHPrognosis in schizophrenia: prognostic predictors and outcome. Arch Gen Psychiatry 1978;35(1):72–77.CrossRefGoogle ScholarPubMed
Juola, PMiettunen, JVeijola, JIsohanni, MJääskeläinen, EPredictors of short–and long-term clinical outcome in schizophrenic psychosis–the Northern Finland 1966 Birth Cohort study. Eur Psychiatry 2013;28(5):263–268.CrossRefGoogle ScholarPubMed
Üçok, AGorwood, PKaradayi, GEmployment and its relationship with functionality and quality of life in patients with schizophrenia: EGOFORS Study. Eur Psychiatry 2012;27(6):422–425.CrossRefGoogle ScholarPubMed
Schimmelmann, BGConus, PCotton, SMcGorry, PDLambert, MPretreatment, baseline, and outcome differences between early-onset and adult-onset psychosis in an epidemiological cohort of 636 first-episode patients. Schizophr Res 2007;95(1):1–8.CrossRefGoogle Scholar
Zaytseva, YKorsakova, NGurovich, ICourse of cognitive functioning in first episode of schizophrenia prior to the age of onset: 5-year follow-up study. Eur Psychiatry 2010;25:1716.CrossRefGoogle Scholar
Linke, MJankowski, KSCiolkiewicz, AJedrasik-Styla, MParnowska, DGruszka, A, et al.Age or age at onset? Which of them really matters for neuro and social cognition in schizophrenia?. Psychiatry Res 2015;225(1):197–201.CrossRefGoogle ScholarPubMed
Rajji, TKVoineskos, ANButters, MAMiranda, DArenovich, TMenon, M, et al.Cognitive performance of individuals with schizophrenia across seven decades: a study using the MATRICS consensus cognitive battery. Am J Geriatr Psychiatry 2013;21(2):108–118.CrossRefGoogle ScholarPubMed
Howard, RCastle, DWessely, SMurray, RA comparative study of 470 cases of early-onset and late-onset schizophrenia. Br J Psychiatry 1993;163(3):352–357.CrossRefGoogle ScholarPubMed
Howard, RRabins, PVSeeman, MVJeste, DV Late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: an international consensus. Am J Psychiatry 2000CrossRefGoogle Scholar
Liu, JJNorman, RMManchanda, RDe Luca, VAdmixture analysis of age at onset in schizophrenia: evidence of three subgroups in a first-episode sample. Gen Hosp psychiatry 2013;35(6):664–667.CrossRefGoogle Scholar
Selvendra, ABaetens, DTrauer, TPetrakis, MCastle, DFirst episode psychosis in an adult area mental health service–a closer look at early and late-onset first episode psychosis. Australas Psychiatry 2014;22(3):235–241.CrossRefGoogle Scholar
Greenfield, PJoshi, SChristian, SLekkos, PGregorowicz, AFisher, HL, et al.First episode psychosis in the over 35 s: is there a role for early intervention?. Early Interv Psychiatry 2016. http://dx.doi.org/10.1111/eip.12322.CrossRefGoogle Scholar
Yung, ARYuen, HPMcGorry, PDPhillips, LJKelly, DDell’Olio, M, et al.Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust and N Z J Psychiatry 2005;39(11–12):964–971.CrossRefGoogle ScholarPubMed
Baumann, PSCrespi, SMarion-Veyron, RSolida, AThonney, JFavrod, J, et al.Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne): implementation of an early intervention programme for psychosis in Switzerland. Early Interv Psychiatry 2013;7(3):322–328.CrossRefGoogle Scholar
Marion-Veyron, RMebdouhi, NBaumann, PSThonney, JCrespi, SConus, PLes premiers épisodes psychotiques : de l’importance du case management. Evol Psychiatr 2013;78(1):41–51.CrossRefGoogle Scholar
American Psychiatric, Association, Diagnostic and statistical manual of mental disorders (DSM) Washington, DC: American psychiatric association; 1994. p. 143–147.Google Scholar
Chandola, TJenkinson, CThe new UK National Statistics Socio-Economic Classification (NS-SEC); investigating social class differences in self-reported health status. J Public Health 2000;22(2):182–190.CrossRefGoogle ScholarPubMed
Tohen, MHennen, JZarate, CM Jr.Baldessarini, RJStrakowski, SMStoll, AL, et al.Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic features. Am J Psychiatry 2000;157(2):220–228.CrossRefGoogle ScholarPubMed
Dilling, HDittmann, V[Psychiatric diagnosis following the 10th revision of the International Classification of Diseases (ICD-10)]. Der Nervenarzt 1990;61(5):259–270.Google Scholar
Cannon-Spoor, HEPotkin, SGWyatt, RJMeasurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982;8(3):470.CrossRefGoogle ScholarPubMed
MacBeth, AGumley, APremorbid adjustment, symptom development and quality of life in first episode psychosis: a systematic review and critical reappraisal. Acta Psychiatrica Scandinavica 2008;117(2):85–99.CrossRefGoogle ScholarPubMed
Alameda, LFerrari, CBaumann, PGholam-Razaee, MDo, KQConus, PChildhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients. Psychol Med 2015;45(13):2727–2736.CrossRefGoogle ScholarPubMed
Alameda, LGolay, PBaumann, PFerrari, CDo, KQConus, PAge at the time of exposure to trauma modulates the psychopathological profile in early psychosis patients. J Clin Psychiatry 2016;77(5):e612–e618.CrossRefGoogle Scholar
Conus, PCotton, SSchimmelmann, BGMcGorry, PDLambert, MThe First-Episode Psychosis Outcome Study: premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patients. Early Interv Psychiatry 2007;1(2):191–200.CrossRefGoogle Scholar
Kay, SRFlszbein, AOpfer, LAThe positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13(2):261.CrossRefGoogle Scholar
Montgomery, SAAsberg, MA new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134(4):382–389.CrossRefGoogle ScholarPubMed
Kay, SROpler, LASpitzer, RLWilliams, JB, et al.SCID-PANSS: two-tier diagnostic system for psychotic disorders. Compr Psychiatry 1991;32(4):355–361.CrossRefGoogle ScholarPubMed
Andreasen, NCCarpenter, WT Jr.Kane, JMLasser, RAMarder, SRWeinberger, DRRemission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005;162(3):441–449.CrossRefGoogle ScholarPubMed
Strakowski, SMKeck, PEMcElroy, SLWest, SASax, KWHawkins, JM, et al.Twelve-month outcome after a first hospitalization for affective psychosis. Archives Gen Psychiatry 1998;55(1):49–55.CrossRefGoogle ScholarPubMed
Apeldoorn, SSterk, Bvan den Heuvel, ESchoevers, RIslam, MInvestigators, OoP.Factors contributing to the duration of untreated psychosis. Schizophr Res 2014;158(1):76–81.CrossRefGoogle ScholarPubMed
Schimmelmann, BGHuber, CGLambert, MCotton, SMcGorry, PDConus, PImpact of duration of untreated psychosis on Pretreatment, baseline and outcome characteristics in an epidemiological first-episode psychosis cohort. J Psychiatric Res 2008;42(12):982–990.CrossRefGoogle Scholar
Castle, DJWomen and schizophrenia: an epidemiological perspective. Women and schizophrenia Cambridge: Cambridge University Press; 2000. p. 19–34.Google Scholar
Harris, MJJeste, DVLate-onset schizophrenia: an overview. Schizophr Bull 1988;14(1):39.CrossRefGoogle ScholarPubMed
Harvey, PLate-onset schizophrenia: characteristics of patients at the first episode. The early course of schizophrenia; 2006; 175.Google Scholar
Thorup, AWaltoft, BLPedersen, CBMortensen, PBNordentoft, MYoung males have a higher risk of developing schizophrenia: a Danish register study. Psychol Med 2007;37(04):479–484.CrossRefGoogle ScholarPubMed
Lysaker, PHNees, MALancaster, RSDavis, LWVocational function among persons with schizophrenia with and without history of childhood sexual trauma. J Trauma Stress 2004;17(5):435–438.CrossRefGoogle ScholarPubMed
Conus, PCotton, SSchimmelmann, BGMcGorry, PDLambert, MPretreatment and outcome correlates of sexual and physical trauma in an epidemiological cohort of first-episode psychosis patients. Schizophr Bull 2010;36(6):1105–1114.CrossRefGoogle Scholar
Stain, HJBrønnick, KHegelstad, WTJoa, IJohannessen, JOLangeveld, J, et al.Impact of interpersonal trauma on the social functioning of adults with first-episode psychosis. Schizophr Bull 2013;40(6):1491–1498.CrossRefGoogle ScholarPubMed
Trotta, AMurray, RMDavid, ASKolliakou, AO’Connor, JDi Forti, M, et al.Impact of different childhood adversities on 1-year outcomes of psychotic disorder in the genetics and psychosis study. Schizophr Bull 2016;42(2):464–475.CrossRefGoogle ScholarPubMed
Riecher-Rössler, AHäfner, HGender aspects in schizophrenia: bridging the border between social and biological psychiatry. Acta Psychiatrica Scandinavica 2000;102(s407):58–62.CrossRefGoogle Scholar
Dutoit, MBesse, CHausmann, PSpagnoli, DBonsack, CUne expérience de soutien à l’emploi pour les personnes souffrant de troubles psychiques en Suisse romande. Rev Med Suisse 2014;10:1711–1714.Google Scholar
Chase, GACohen, BA chart review study of late-onset and early-onset schizophrenia. Am J Psychiatry 1989;146(12):1569.Google Scholar
Howard, RGraham, CSham, PDennehey, JCastle, DLevy, R, et al.A controlled family study of late-onset non-affective psychosis (late paraphrenia). Br J Psychiatry 1997;170(6):511–514.CrossRefGoogle Scholar
Jeste, DVSymonds, LLHarris, MJPaulsen, JSPalmer, BWHeaton, RKNondementia nonpraecox dementia praecox?: late-onset schizophrenia. Am J Geriatr Psychiatry 1997;5(4):302–317.CrossRefGoogle ScholarPubMed
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