Exploring Clinical Features of Early Onset Schizophrenia at Somdet Chaopraya Institute of Psychiatry
Article Sidebar
Main Article Content
Abstract
Objective: Schizophrenia is a major psychiatric disorder that causes significant functional impairment. When onset occur in childhood or adolescence, it is considered a neurodevelopmental disorder and is associated with greater severity and poor prognosis. This study investigates the clinical features of schizophrenia in adolescents aged 14 to 18 years at the supra-tertiary psychiatric hospital in Bangkok and association between stable versus severe group and clinical variables.
Methods: In a descriptive retrospective study (N = 96), all patients aged 14 to 18 years who received the first diagnosis of schizophrenia at Somdet Chaopraya Psychiatric Institute between 2018 and 2023 were included in the study. Descriptive statistics were used to characterize the sample. Associations between clinical factors and illness severity were analyzed using chi-square or Fisher’s exact tests, and odds ratio (OR) were estimated using univariable logistic regression.
Results: The study included 96 participants who met the inclusion criteria. Among these, 75% were male, with a mean age diagnosis of 16.8 years. Comorbidities were present in 36.6% of the cases, with substance use disorder being the most prevalent. Among this cannabis users were the most frequently reported. Prior to the schizophrenia diagnosis, 54.2% of participants had been diagnosed with other mental health conditions, most frequently substance-induced psychosis. However, no statistically significant associations were observed between the study variables and illness severity (stable vs. severe groups).
Conclusion: Early onset schizophrenia was characterized by predominance of male patients with high rate of comorbid substance use. These findings highlight the importance of substance use prevention policy in Thailand. Behavioral changes were the most common prodromal manifestation, and this information may contribute to earlier detection of the disorder.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles submitted for consideration must not have been previously published or accepted for publication in any other journal, and must not be under review by any other journal.
References
Boland R, Verduin M. Schizophrenia spectrum and other psychotic disorders. In: Boland R, Verduin M, Ruiz P, editors. Kaplan and Sadock's Synopsis of Psychiatry. 12th ed. Philadelphia: Wolters Kluwer; 2022. p. 337-64.
Kendhari J, Shankar R, Young-Walker L. A review of childhood-onset schizophrenia. Focus (Am Psychiatr Publ) 2016; 14(3): 328-32.
Boland R, Verduin M. Neurodevelopmental disorders and other childhood disorders. In: Boland R, Verduin M, Ruiz P, editors. Kaplan and Sadock's Synopsis of Psychiatry. 12th ed. Philadelphia: Wolters Kluwer; 2022. p. 93-223.
Lotrakul M, Sukanich P. Ramathibodi Psychiatry. 4th ed. Bangkok: Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital; 2015.
Yung AR, McGorry PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 1996; 22(2): 353-70.
Driver D, Thomas S, Gogtay N, Rapoport J. Childhood-onset schizophrenia and early onset schizophrenia spectrum disorders: an update. Child Adolesc Psychiatr Clin N Am 2020; 29(1): 71-90.
Hill C, Palaniyappan L. Schizophrenia and psychosis. In: Thapar A, Pine DS, Leckman JF, Scott S, Snowling MJ, editors. Rutter's Child and Adolescent Psychiatry. 6th ed. Oxford: Wiley Blackwell; 2015. p. 774-94.
Malaspina D, Harlap S, Fennig S, Heiman D, Nahon D, Feldman D, et al. Advancing paternal age and the risk of schizophrenia. Arch Gen Psychiatry 2001; 58: 361-7.
Cannon M, Caspi A, Moffitt TE, Harrington H, Taylor A, Murray RM, et al. Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder results from a longitudinal birth cohort. Arch Gen Psychiatry 2002; 59: 449-56.
Verdoux H, Geddes J, Takei N, Lawrie SM, Bovet P, Eagles JM, et al. Obstetric complications and age at onset in schizophrenia: An International Collaborative Meta-Analysis of Individual Patient Data. Am J Psychiatry 1997; 154(9): 1220–7.
McGrath J, Murray R. Risk factors for schizophrenia: from conception to birth in schizophrenia. In: Hirsch SR, Weinberger DR, editors. Schizophrenia. Oxford: Blackwell Science; 1995. p. 187-205.
Arseneault L, Cannon M, Witton J, Murray R. Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry 2004; 184: 110-7.
Large M, Sharma S, Compton MT, Slade T, Nielssen O. Cannabis use and earlier onset of psychosis a systematic meta-analysis. Arch Gen Psychiatry 2011; 68: 555-61.
Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ 2002; 325: 1212-3.
Inyang B, Gondal FJ, Abah GA, Dhandapani MM, Manne M, Khanna M, et al. The role of childhood trauma in psychosis and schizophrenia: a systematic review. Cureus 2022; 14(1): e21466.
Lo LE, Kaur R, Meiser B, Green MJ. Risk of schizophrenia in relatives of individuals affected by schizophrenia: A meta-analysis. Psychiatry Res 2020; 286: 112901.
Cannon TD, Kaprio J, Lönnqvist J, Huttunen M, Koskenvuo M. The genetic epidemiology of schizophrenia in a Finnish twin cohort: a population-based modeling study. Arch Gen Psychiatry 1998; 55: 67-74.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. text rev. Washington, DC: American Psychiatric Publishing; 2022.
Gadelha A, Biokino RM, Lorencetti P, Crossley NA, Bordini D, Massuda R. Introducing a new severity specifier for schizophrenia: conceptual framework and clinical implications. Braz J Psychiatry 2024; 46: e20243722.
National Institute for Health and Care Excellence. Guidance on the use of electroconvulsive therapy: technology appraisal guidance TA59 [Internet]. London (GB): National Institute for Health and Care Excellence; 2003 [updated 2009 Oct 1; cited 2026 Feb 17]. Available from: https://www.nice.org.uk/guidance/ta59
Poovichayasumlit C, Limsuwan N. Clinical presentations of early-onset schizophrenia: a 10-year retrospective chart review. J Med Assoc Thai 2023; 106: 172-9.
Kessler T, Lev-Ran S. The association between comorbid psychiatric diagnoses and hospitalization-related factors among individuals with schizophrenia. Compr Psychiatry 2019; 89: 7-15.
Nunez MB, Dhingra A, Dhingra M, Kossack R, Dhingra M. Kratom's rising role in the potential exacerbation of mental health disorders: a case report and review of the literature. Psychiatry Res Case Rep 2022; 1(2):100069.
Levi L, Bar-Haim M, Winter-van Rossum I, Davidson M, Leucht S, Fleischhacker WW, et al. Cannabis use and symptomatic relapse in first episode schizophrenia: trigger or consequence? Data from the OPTIMISE study. Schizophr Bull 2023; 49(4): 903-13.
Immonen J, Jääskeläinen E, Korpela H, Miettunen J. Age at onset and the outcomes of schizophrenia: a systematic review and meta-analysis. Early Interv Psychiatry 2017; 11(6): 453-60.
