Brian O’Donoghue1,2,3, Patrick McGorry1,2; 1Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia, 2Centre for Youth Mental Health, University of Melbourne, Australia, 3Orygen Youth Health, 35 Poplar rd, Parkville, VIC 3052, Australia
It has been suggested that early onset psychosis (before the age of 18) may represent a more severe variant of the disorder as a number of studies have indicated a poorer outcome in this sub-group. However more recent evidence has suggested that those with early onset have a more favourable course of illness and outcome. Methods: This study was conducted at the Early Psychosis Prevention and Intervention Centre (EPPIC) and included all young people aged 15 to 24 who presented with a first episode of psychosis (FEP) in a defined catchment in Melbourne between 01/01/11 and 31/12/13. The management at EPPIC includes psychopharmacology, cognitive behavioural therapy and psychosocial interventions. Results: A total of 544 young people presented with a FEP during the three year period and 37.1% had an onset before the age of 18. Young people with an early onset psychotic disorder were more likely to be female, be born in Australia, have a diagnosis of Psychosis NOS and less likely to have a concurrent substance abuse disorder. 42% of young people with early onset psychotic disorder experienced a relapse following symptomatic remission, which was comparable to those with a later onset. Functional outcomes were superior in those with an early onset, with 60% returning to either school or work by the time of discharge, compared to 50% of those with a later onset. Conclusions: These results indicate that with the appropriate management, young people with an early onset of a psychotic disorder can have positive outcomes.
