Predictors of later schizophrenia and affective psychosis among attendees at a child psychiatry department

Abstract

Background: Schizophrenia has been linked with psychological problems in childhood but there is little information on precursors of affective psychosis.

Aims: To compare childhood psychological antecedents of adult schizophrenia and affective psychosis.

Method: Childhood item sheets, which give standardised information on signs and symptoms of mental illness in the year preceding assessment are completed for all attendees at the children's department of the Maudsley and Bethlem Royal Hospital. We examined item sheet data on individuals with an adult diagnosis of schizophrenia (n=59) or affective psychosis (n=27) and a comparison group with no adult mental illness (n=86) (all had attended the department).

Results: Abnormal suspiciousness or sensitivity and relationship difficulties with peers are associated with later schizophrenia. In contrast, affective psychosis is associated with childhood hysterical symptoms and disturbances in eating.

Conclusions: Childhood psychological precursors for schizophrenia and affective psychosis differ and do not simply reflect non-specific psychiatric disturbance in adolescence.