Volume 23, Issue 3 (Fall 2017)                   IJPCP 2017, 23(3): 306-319 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shahrivar Z, Mahmoodi Gharaei J, Zare'i M, Zarrabi M, Shirazi E. Clinical Characteristics, Function, Quality of Life, and Premorbid Adjustment in Children and Adolescents With First-Episode Psychosis Admitted at Roozbeh Hospital. IJPCP. 2017; 23 (3) :306-319
URL: http://ijpcp.iums.ac.ir/article-1-2490-en.html
1- Research Center for Cognitive and Behavioral Sciences, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran-Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran , E-mail: sharivar@sina.tums.ac.ir
2- Research Center for Cognitive and Behavioral Sciences, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
3- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
4- Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
5- Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
Abstract:   (1492 Views)
Objectives This study was done to evaluate the clinical characteristics, function, quality of life, and premorbid 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 psychiatric 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 Assessment 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 suffering 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 suicidal 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 impairment. These findings confirm the need for prevention and early interventions in at-risk individuals.
 
Full-Text [PDF 6653 kb]   (524 Downloads) |   |   Full-Text (HTML)  (516 Views)  
Type of Study: Original Research | Subject: General
Received: 2016/05/3 | Accepted: 2017/01/25 | Published: 2017/10/1

References
1. Schimmelmann BG, Conus P, Schacht M, Mcgorry P, Lambert M. Predictors of service disengagement in first admitted adolescents with psychosis. Journal of the American Academy of Child & Adolescent Psychiatry. 2006; 45(8):990–9. doi: 10.1097/01.chi.0000223015.29530.65 [DOI:10.1097/01.chi.0000223015.29530.65]
2. Noguera A, Ballesta P, Baeza I, Arango C, de la Serna E, González Pinto A, et al. Twenty four months of antipsychotic treatment in children and adolescents with first psychotic episode. Journal of Clinical Psychopharmacology. 2013; 33(4):463–71. doi: 10.1097/jcp.0b013e3182962480 [DOI:10.1097/JCP.0b013e3182962480]
3. Castro Fornieles J, Parellada M, Gonzalez Pinto A, Moreno D, Graell M, Baeza I, et al. The child and adolescent first-episode psychosis study (CAFEPS): Design and baseline results. Schizophrenia Research. 2007; 91(1-3):226–37. doi: 10.1016/j.schres.2006.12.004 [DOI:10.1016/j.schres.2006.12.004]
4. Janssen J, Reig S, Parellada M, Moreno D, Graell M, Fraguas D, et al. Regional gray matter volume deficits in adolescents with first-episode psychosis. Journal of the American Academy of Child & Adolescent Psychiatry. 2008; 47(11):1311–20. doi: 10.1097/chi.0b013e318184ff48 [DOI:10.1097/CHI.0b013e318184ff48]
5. Amini H, Alaghbandrad J, Omid A, Sharifi V, Davari Ashtiani R, Momeni F, et al. Diagnostic stability in patients with first-episode psychosis. Australasian Psychiatry. 2005; 13(4):388–92. doi: 10.1111/j.1440-1665.2005.02199.x [DOI:10.1111/j.1440-1665.2005.02199.x]
6. Alaghbandrad J., Amini H., Sharifi V., Dashti B. A 2 year followup study on patients with first episode psychosis admitted to Roozbeh Hospital: Demographic and clinical characteristics and comparison of a specialized program and treatment as usual, Final Report. Tehran: Tehran University of Medical Sciences; 2010.
7. Sharifi V, Amini H, Shahrivar Z, Mottaghipour Y, Mahmoudi Gharaee J, Alaghband Rad J. Courseof psychotic disorders: A 3-year follow up study of patients with first episode psychosis. Iranian Journal of Psychiatry and Clinical Psychology. 2014; 20(1):35-42.
8. Shahrivar Z, Alaghband Rad J, Mahmoudi Gharaie J, Seddigh A, Salesian N, Jalali Roodsari M, et al. The efficacy of an integrated treatment in comparison with treatment as usual in a group of children and adolescents with first episode psychosis during a two year follow up. Iranian Journal of Psychiatry and Clinical Psychology. 2012; 18(2):115-37.
9. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry. 1997; 36(7):980–8. doi: 10.1097/00004583-199707000-00021 [DOI:10.1097/00004583-199707000-00021]
10. Shahrivar Z, Kousha M, Moallemi S, Tehrani Doost M, Alaghband Rad J. The reliability and validity of kiddie schedule for affective disorders and schizophrenia present and life time version - persian version. Child and Adolescent Mental Health. 2010; 15(2):97–102. doi: 10.1111/j.1475-3588.2008.00518.x [DOI:10.1111/j.1475-3588.2008.00518.x]
11. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin. 1987; 13(2):261–76. doi: 10.1093/schbul/13.2.261 [DOI:10.1093/schbul/13.2.261]
12. Bates MP. The child and adolescent functional assessment scale (CAFAS): Review and current status. Clinical Child and Family Psychology Review. 2001; 4(1):63-84. [DOI:10.1023/A:1009528727345] [PMID]
13. Patterson DA, Lee MS. Field trial of the Global Assessment of Functioning Scale--Modified. American Journal of Psychiatry. 1995; 152(9):1386–8. doi: 10.1176/ajp.152.9.1386 [DOI:10.1176/ajp.152.9.1386]
14. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, et al. A children's global assessment scale (CGAS). Archives of General psychiatry. 1983; 40(11):1228-31. doi: 10.1001/archpsyc.1983.01790100074010 [DOI:10.1001/archpsyc.1983.01790100074010]
15. Blake K, Cangelosi S, Johnson Brooks S, Belcher HME. Reliability of the GAF and CGAS with children exposed to trauma. Child Abuse & Neglect. 2007; 31(8):909–15. doi: 10.1016/j.chiabu.2006.12.017 [DOI:10.1016/j.chiabu.2006.12.017]
16. World Health Organization. WHOQOL-BREF: Introduction, administration and scoring, Field Trial version. Geneva: World Health Organization; 1996.
17. Nedjat S, Montazeri A, Holakouie K, Mohammad K, Majdzadeh R. Psychometric properties of the Iranian interview-administered version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF): A population based study. BMC Health Services Research. 2008; 8(1):61. doi: 10.1186/1472-6963-8-61 [DOI:10.1186/1472-6963-8-61]
18. Nejat SA, Montazeri A, Holakouie Naieni K, Mohammad KA, Majdzadeh SR. The World Health Organization quality of Life (WHOQOL-BREF) questionnaire: Translation and validation study of the Iranian version. Journal of School of Public Health and Institute of Public Health Research. 2006; 4(4):1-2.
19. Krauss H, Marwinski K, Held T, Rietschel M, Freyberger HJ. Reliability and validity of the Premorbid Adjustment Scale (PAS) in a German sample of schizophrenic and schizoaffective patients. European Archives of Psychiatry and Clinical Neuroscience. 1998; 248(6):277–81. doi: 10.1007/s004060050050 [DOI:10.1007/s004060050050]
20. Brill N, Reichenberg A, Weiser M, Rabinowitz J. Validity of the premorbid adjustment scale. Schizophrenia Bulletin. 2008; 34(5):981–3. doi: 10.1093/schbul/sbm128 [DOI:10.1093/schbul/sbm128]
21. Mahmoodi Gharaei J, Basirnia A, Abedi N, Shadloo B, Jafari S, Salesian N, et al. Association of premorbid adjustment with symptom profile and quality of life in first episode psychosis in a tertiary hospital in Tehran, Iran. Iranian Journal of P sychiatry. 2010; 5(1):23-27. PMCID: PMC3430406 [PMID] [PMCID]
22. Harper A, Power M, Orley J, Herrman H, Schofield H, Murphy B, et al. Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological Medicine. 1998; 28(3):551–8. doi: 10.1017/s0033291798006667 [DOI:10.1017/S0033291798006667]
23. Driver DI, Gogtay N, Rapoport JL. Childhood onset schizophrenia and early onset schizophrenia spectrum disorders. Child and Adolescent Psychiatric Clinics of North America. 2013; 22(4):539–55. doi: 10.1016/j.chc.2013.04.001 [DOI:10.1016/j.chc.2013.04.001]
24. Schreier HA. Hallucinations in nonpsychotic children: More Common than we think. Journal of the American Academy of Child & Adolescent Psychiatry. 1999; 38(5):623–5. doi: 10.1097/00004583-199905000-00028 [DOI:10.1097/00004583-199905000-00028]
25. Jarbin H., Ott Y., Von Knorring AL. Adult outcome of social function in adolescent onset schizophrenia and affective psychosis. Journal of the American Academy of Child & Adolescent Psychiatry. 2003; 42(2):176–83. doi: 10.1097/00004583-200302000-00011 [DOI:10.1097/00004583-200302000-00011]
26. Noguera A, Ballesta P, Baeza I, Arango C, de la Serna E, González Pinto A, et al. Twenty four months of antipsychotic treatment in children and adolescents with first psychotic episode. Journal of Clinical Psychopharmacology. 2013; 33(4):463–71. Doi: 10.1097/jcp.0b013e3182962480 [DOI:10.1097/JCP.0b013e3182962480]
27. Macmillan I, Howells L, Kale K, Hackmann C, Taylor G, Hill K, et al. Social and symptomatic outcomes of first episode bipolar psychoses in an early intervention service. Early Intervention in Psychiatry. 2007; 1(1):79–87. doi: 10.1111/j.1751-7893.2007.00014.x [DOI:10.1111/j.1751-7893.2007.00014.x]
28. Rabinowitz J, De Smedt G, Harvey PD, Davidson M. Relationship between premorbid functioning and symptom severity as assessed at first episode of psychosis. American Journal of Psychiatry. 2002; 159(12):2021–6. doi: 10.1176/appi.ajp.159.12.2021 [DOI:10.1176/appi.ajp.159.12.2021]
29. Castro Fornieles J, Parellada M, Gonzalez Pinto A, Moreno D, Graell M, Baeza I, et al. The child and adolescent first episode psychosis study (CAFEPS): Design and baseline results. Schizophrenia Research. 2007; 91(1-3):226–37. doi: 10.1016/j.schres.2006.12.004 [DOI:10.1016/j.schres.2006.12.004]
30. Falcone T, Mishra L, Carlton E, Lee C, Butler R, Janigro D, et al. Suicidal behavior in adolescents with first episode psychosis. Clinical Schizophrenia & Related Psychoses. 2010; 4(1):34–40. doi: 10.3371/csrp.4.1.2 [DOI:10.3371/CSRP.4.1.2]
31. Chung YC, Jung HY, Kim SW, Lee SH, Shin SE, Shin YM, et al. What factors are related to delayed treatment in individuals at high risk for psychosis. Early Intervention in Psychiatry. 2010; 4(2):124–31. doi: 10.1111/j.1751-7893.2010.00170.x [DOI:10.1111/j.1751-7893.2010.00170.x]
32. Shin YM, Jung HY, Kim SW, Lee SH, Shin SE, Park JI, et al. A descriptive study of pathways to care of high risk for psychosis adolescents in Korea. Early Intervention in Psychiatry. 2010; 4(2):119–23. doi: 10.1111/j.1751-7893.2010.00180.x [DOI:10.1111/j.1751-7893.2010.00180.x]
33. Sharifi V, Kermani Ranjbar T, Amini H, Alaghband Rad J, Salesian N, Seddigh A. Duration of untreated psychosis and pathways to care in patients with first episode psychosis in Iran. Early Intervention in Psychiatry. 2009; 3(2):131–6. doi: 10.1111/j.1751-7893.2009.00119.x [DOI:10.1111/j.1751-7893.2009.00119.x]
34. Archie S, Wilson JH, Woodward K, Hobbs H, Osborne S, McNiven J. Psychotic disorders clinic and first episode psychosis: A program evaluation. The Canadian Journal of Psychiatry. 2005; 50(1):46–51. doi: 10.1177/070674370505000109 [DOI:10.1177/070674370505000109]
35. Ballageer T, Malla A, Manchanda R, Takhar J, Haricharan R. Is adolescent onset first episode psychosis different from adult onset. Journal of the American Academy of Child & Adolescent Psychiatry. 2005; 44(8):782–9. doi: 10.1097/01.chi.0000164591.55942.ea [DOI:10.1097/01.chi.0000164591.55942.ea]
36. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association between duration of untreated psychosis and outcome in cohorts of first episode patients. Archives of General Psychiatry. 2005; 62(9):975. doi: 10.1001/archpsyc.62.9.975 [DOI:10.1001/archpsyc.62.9.975]

Add your comments about this article : Your username or Email:
CAPTCHA code

Send email to the article author


© 2018 All Rights Reserved | Iranian Journal of Psychiatry and Clinical Psychology

Designed & Developed by : Yektaweb