Clinical Characteristics, Function, Quality of Life, and Premorbid Adjustment in Children and Adolescents With First-Episode Psychosis Admitted at Roozbeh Hospital

Abstract

Objectives This study was done to evaluate the clinical characteristics, function, quality of life, and pre-morbid adjustment of inpatient children and adolescents with First-Episode Psychosis (FEP) at Roozbeh psychiatric hospital. Methods During a two-year cohort study (2013-2014), all admissions in the child and adolescent psychi-atric ward were evaluated. Diagnoses were made using clinical assessment and the Kiddie Schedule for Affective Disorder and Schizophrenia-Present and Lifetime Version-Persian Version (K-SADS-LV-PV). The Positive and Negative Symptoms Scale (PANSS), Premorbid Adjustment Scale (PAS), Clinical Global As-sessment Scale (CGAS), and WHO-Quality of Life-Brief (WHOQOL-Brief) were used to assess the related variables. Results Among 44 participants (47.7% boys) with a mean age of 193.11(21.5) months, 68.3% were suf-fering from Bipolar Disorder (BD) and 15.9% from Schizophrenia. Poor premorbid adjustment before the emergence of psychosis was indirectly related with academic level and directly consistent with sui-cidal risk and duration of psychotic disorder (P<0.05). The level of premorbid global functioning was higher than 80% only in 7% of the participants. This score was less than 40% in 95% of the participants during admission. Conclusion Bipolar disorder was the most common diagnosis among the child and adolescent inpatients with FEP. FEP was consistent with poor premorbid adjustment and severe global functioning impair-ment. These findings confirm the need for prevention and early interventions in at-risk individuals.