Premorbid impairments in early-onset psychosis: differences between patients with schizophrenia and bipolar disorder

Abstract

Background: Despite the large body of research on premorbid impairments in schizophrenia, studies comparing different early-onset psychoses are scarce.

Aims: To examine premorbid impairments in first episodes of early-onset bipolar and schizophrenia disorders.

Method: We compared premorbid adjustment and other premorbid variables such as IQ and developmental abnormalities in a cohort of children and adolescents (N=69) with bipolar disorder (BP) or schizophrenia (SZ) experiencing their first psychotic episode and in a healthy control group (N=91).

Results: Schizophrenia patients showed more social impairment in childhood than bipolar patients (p<0.05) and healthy controls (p<0.001) and had higher rates of developmental abnormalities (p<0.05) than healthy controls. Between childhood and early adolescence, schizophrenia and bipolar patients showed a greater decline in academic adjustment than healthy controls, more specifically in adaptation to school (p<0.01).

Conclusions: Early-onset schizophrenia patients show more early social impairment than early-onset bipolar patients. Intellectual premorbid abnormalities are less specific and probably more linked to early-onset psychosis.