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Multicenter Study
. 2024 Mar;33(3):799-810.
doi: 10.1007/s00787-023-02196-7. Epub 2023 Apr 7.

Prodromal symptoms and the duration of untreated psychosis in first episode of psychosis patients: what differences are there between early vs. adult onset and between schizophrenia vs. bipolar disorder?

Inmaculada Baeza  1   2   3   4 , Elena de la Serna  5   6 , Gisela Mezquida  6   7   8 , Manuel J Cuesta  9 , Eduard Vieta  6   10   7   11 , Silvia Amoretti  6   7   11   12 , Antonio Lobo  6   13 , Ana González-Pinto  6   14 , Covadonga M Díaz-Caneja  6   15 , Iluminada Corripio  6   16 , Isabel Valli  10   17 , Olga Puig  5   6   7 , Anna Mané  6   18 , Miquel Bioque  6   10   7   8 , Miriam Ayora  6   15 , Miquel Bernardo  6   10   7   8 , Josefina Castro-Fornieles  5   6   10   7 ; PEPs group
Collaborators, Affiliations
Multicenter Study

Prodromal symptoms and the duration of untreated psychosis in first episode of psychosis patients: what differences are there between early vs. adult onset and between schizophrenia vs. bipolar disorder?

Inmaculada Baeza et al. Eur Child Adolesc Psychiatry. 2024 Mar.

Abstract

To assess the role of age (early onset psychosis-EOP < 18 years vs. adult onset psychosis-AOP) and diagnosis (schizophrenia spectrum disorders-SSD vs. bipolar disorders-BD) on the duration of untreated psychosis (DUP) and prodromal symptoms in a sample of patients with a first episode of psychosis. 331 patients with a first episode of psychosis (7-35 years old) were recruited and 174 (52.6%) diagnosed with SSD or BD at one-year follow-up through a multicenter longitudinal study. The Symptom Onset in Schizophrenia (SOS) inventory, the Positive and Negative Syndrome Scale and the structured clinical interviews for DSM-IV diagnoses were administered. Generalized linear models compared the main effects and group interaction. 273 AOP (25.2 ± 5.1 years; 66.5% male) and 58 EOP patients (15.5 ± 1.8 years; 70.7% male) were included. EOP patients had significantly more prodromal symptoms with a higher frequency of trouble with thinking, avolition and hallucinations than AOP patients, and significantly different median DUP (91 [33-177] vs. 58 [21-140] days; Z = - 2.006, p = 0.045). This was also significantly longer in SSD vs. BD patients (90 [31-155] vs. 30 [7-66] days; Z = - 2.916, p = 0.004) who, moreover had different profiles of prodromal symptoms. When assessing the interaction between age at onset (EOP/AOP) and type of diagnosis (SSD/BD), avolition was significantly higher (Wald statistic = 3.945; p = 0.047), in AOP patients with SSD compared to AOP BD patients (p = 0.004). Awareness of differences in length of DUP and prodromal symptoms in EOP vs. AOP and SSD vs. BD patients could help improve the early detection of psychosis among minors.

Keywords: Adult onset; Children and adolescents; Prodromal symptoms; Prodrome; Schizophrenia, bipolar disorder, early onset.

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Conflict of interest statement

IB has received honoraria and travel support from Angelini, Otsuka-Lundbeck and Janssen, grants from Spanish Ministry of Health, Instituto de Salud Carlos III. EV has received grants and served as consultant, advisor or CME speaker for the following entities (unrelated to the present work): AB-Biotics, Abbvie, Aimentia, Angelini, Biogen, Celon, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Glaxo Smith-Kline, Janssen, Lundbeck, Organon, Otsuka, Sage, Sanofi-Aventis, Sunovion, and Takeda. AG–P has received grants and served as consultant, advisor or CME speaker for the following entities: Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Sanofi-Aventis, Alter, Angelini, Exeltis, Takeda, the Spanish Ministry of Science and Innovation (CIBERSAM),the Ministry of Science (Carlos III Institute), the Basque Government, and the European Framework Program of Research. CD-C holds grants from Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (PI17/00481, PI20/00721, JR19/00024) and has received fees from Exeltis and Angelini. AM has served as a speaker and received honoraria for travel expenses /attending conferences from Otsuka and Angelini. M. Bioque has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of has received honoraria from talks and/or consultancy of Adamed, Angelini, Casen-Recordati, Ferrer, Janssen-Cilag, Lundbeck, Neuraxpharm, Otsuka, Pfizer and Sanofi, and grants from Spanish Ministry of Health, Instituto de Salud Carlos III (PI20/01066). MA has held a Río Hortega grant from Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation). M. Bernardo has been a consultant for, received grant/ research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, Angelini, Casen Recordati, Janssen-Cilag, Menarini, Rovi and Takeda. CG-R has received honoraria/travel support from Adamed, Angelini, Janssen-Cilag and Lundbeck. JG-D has been an advisor/speaker for, or received travel support from Janssen, Eurofarma, Servier, Sanofi, Lilly, and Pfizer. CD-L-C received financial support to attend scientific meetings from Janssen-Cilag, Almirall, Eli Lilly, Lundbeck, Rovi, Esteve, Novartis, and Astrazeneca. NV has received financial support for CME activities and travel funds from the following entities (unrelated to the present work): Angelini, Janssen-Cilag, Lundbeck, Otsuka. MS-V has received financial support for CME activities or travel funds from Janssen-Cilag and Lundbeck, and has served as a speaker for Casen Recordati. GS has received speaker fees by Angelini Pharma. RR-J has been a consultant for, spoken in activities of, or received grants from: Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/ BMD-2422 AGES; S2017/BMD-3740), JanssenCilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini. AI has received research support from or served as speaker or advisor for Janssen-Cilag, Lundbeck and Otsuka. The remaining authors have no personal affiliations or financial relationships with any commercial interests to disclose in connection with the article.

Figures

Fig. 1
Fig. 1
Percentage of prodromal symptoms measured with the Symptom Onset in Schizophrenia (SOS) inventory according to the (A) the age of onset of psychosis, (B) type of diagnosis at one-year assessment, and (C) the age at onset and type of diagnosis at one-year assessment. Footnote. EOP early onset psychosis, AOP adult onset psychosis, SSD schizophrenia Spectrum Disorder; BD = Bipolar disorder, DISORG disorganized. (A) N(EOP) = 58 and N(AOP) = 27; (B) N(SSD) = 133 and N(BD) = 41; C) N(SSD-EOP) = 27, N(SSD-AOP = 106), N(BD-EOP) = 10 and N(BD-AOP) = 31; *p < .05
Fig. 2
Fig. 2
Probability of the prodromal symptom avolition according to age at onset and type of diagnostic at one-year of follow-up
See this image and copyright information in PMC

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