Is it still correct to differentiate between early and very early onset psychosis?

Ashleigh Lin, K.J. Wardenaar, M. Pontillo, F. De Crescenzo, L. Mazzone, S. Vicari, S.J. Wood, A. Beavan, M. Armando

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Abstract

© 2015 Elsevier B.V..Objective: It remains unclear whether very early onset psychosis (VEOP; ≤ 12 years of age) and early onset psychosis (EOP; onset 13-17 years of age) are homogeneous in their clinical presentation. We investigated the predictive value of age of psychosis onset for severity, functioning and demographic variation by: 1) comparing groups based on traditional cut-offs for age of psychosis onset, and 2) using receiver operating characteristic (ROC)-curve calculations, without a priori age of onset cut-offs. Method: Participants were 88 (45 female, 43 male) children and adolescents with a recent onset of psychosis (age range = 6.7-17.5 years; M = 13.74, SD = 2.37). Results: The VEOP group had significantly shorter duration of untreated illness and untreated psychosis, and lower functioning than the EOP group. The VEOP and EOP groups did not differ significantly on gender proportion, urbanicity, psychotic diagnosis, family history of psychotic disorder, psychotic, depressive and anxiety symptoms or IQ. When applying ROC-curves to the lowest three quartiles of positive psychotic symptoms scores, the optimal age-cut-off was 14.0 years (sensitivity = 0.62; specificity = 0.75). For the highest quartile of functioning scores, the optimal differentiating cut-off for age of psychosis onset was 14.7 years (sensitivity = 0.71; specificity = 0.70). Conclusions: Larger samples of patients, assessed at presentation and followed-up, are necessary to clearly examine clinical presentation and outcome as a function of social and neural development to better understand if the differentiation between VEOP and EOP is justified. This will aid the development of predictive diagnostic tools, more accurate prognosis prediction, and age-tailored therapeutic interventions.
Original languageEnglish
Pages (from-to)211-216
JournalSchizophrenia Research
Volume170
Issue number1
Early online date27 Nov 2015
DOIs
Publication statusPublished - Jan 2016

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Psychotic Disorders
Age of Onset
ROC Curve
Sensitivity and Specificity
Anxiety
Demography
Depression

Cite this

Lin, A., Wardenaar, K. J., Pontillo, M., De Crescenzo, F., Mazzone, L., Vicari, S., ... Armando, M. (2016). Is it still correct to differentiate between early and very early onset psychosis? Schizophrenia Research, 170(1), 211-216. https://doi.org/10.1016/j.schres.2015.11.020
Lin, Ashleigh ; Wardenaar, K.J. ; Pontillo, M. ; De Crescenzo, F. ; Mazzone, L. ; Vicari, S. ; Wood, S.J. ; Beavan, A. ; Armando, M. / Is it still correct to differentiate between early and very early onset psychosis?. In: Schizophrenia Research. 2016 ; Vol. 170, No. 1. pp. 211-216.
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abstract = "{\circledC} 2015 Elsevier B.V..Objective: It remains unclear whether very early onset psychosis (VEOP; ≤ 12 years of age) and early onset psychosis (EOP; onset 13-17 years of age) are homogeneous in their clinical presentation. We investigated the predictive value of age of psychosis onset for severity, functioning and demographic variation by: 1) comparing groups based on traditional cut-offs for age of psychosis onset, and 2) using receiver operating characteristic (ROC)-curve calculations, without a priori age of onset cut-offs. Method: Participants were 88 (45 female, 43 male) children and adolescents with a recent onset of psychosis (age range = 6.7-17.5 years; M = 13.74, SD = 2.37). Results: The VEOP group had significantly shorter duration of untreated illness and untreated psychosis, and lower functioning than the EOP group. The VEOP and EOP groups did not differ significantly on gender proportion, urbanicity, psychotic diagnosis, family history of psychotic disorder, psychotic, depressive and anxiety symptoms or IQ. When applying ROC-curves to the lowest three quartiles of positive psychotic symptoms scores, the optimal age-cut-off was 14.0 years (sensitivity = 0.62; specificity = 0.75). For the highest quartile of functioning scores, the optimal differentiating cut-off for age of psychosis onset was 14.7 years (sensitivity = 0.71; specificity = 0.70). Conclusions: Larger samples of patients, assessed at presentation and followed-up, are necessary to clearly examine clinical presentation and outcome as a function of social and neural development to better understand if the differentiation between VEOP and EOP is justified. This will aid the development of predictive diagnostic tools, more accurate prognosis prediction, and age-tailored therapeutic interventions.",
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Lin, A, Wardenaar, KJ, Pontillo, M, De Crescenzo, F, Mazzone, L, Vicari, S, Wood, SJ, Beavan, A & Armando, M 2016, 'Is it still correct to differentiate between early and very early onset psychosis?' Schizophrenia Research, vol. 170, no. 1, pp. 211-216. https://doi.org/10.1016/j.schres.2015.11.020

Is it still correct to differentiate between early and very early onset psychosis? / Lin, Ashleigh; Wardenaar, K.J.; Pontillo, M.; De Crescenzo, F.; Mazzone, L.; Vicari, S.; Wood, S.J.; Beavan, A.; Armando, M.

In: Schizophrenia Research, Vol. 170, No. 1, 01.2016, p. 211-216.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is it still correct to differentiate between early and very early onset psychosis?

AU - Lin, Ashleigh

AU - Wardenaar, K.J.

AU - Pontillo, M.

AU - De Crescenzo, F.

AU - Mazzone, L.

AU - Vicari, S.

AU - Wood, S.J.

AU - Beavan, A.

AU - Armando, M.

PY - 2016/1

Y1 - 2016/1

N2 - © 2015 Elsevier B.V..Objective: It remains unclear whether very early onset psychosis (VEOP; ≤ 12 years of age) and early onset psychosis (EOP; onset 13-17 years of age) are homogeneous in their clinical presentation. We investigated the predictive value of age of psychosis onset for severity, functioning and demographic variation by: 1) comparing groups based on traditional cut-offs for age of psychosis onset, and 2) using receiver operating characteristic (ROC)-curve calculations, without a priori age of onset cut-offs. Method: Participants were 88 (45 female, 43 male) children and adolescents with a recent onset of psychosis (age range = 6.7-17.5 years; M = 13.74, SD = 2.37). Results: The VEOP group had significantly shorter duration of untreated illness and untreated psychosis, and lower functioning than the EOP group. The VEOP and EOP groups did not differ significantly on gender proportion, urbanicity, psychotic diagnosis, family history of psychotic disorder, psychotic, depressive and anxiety symptoms or IQ. When applying ROC-curves to the lowest three quartiles of positive psychotic symptoms scores, the optimal age-cut-off was 14.0 years (sensitivity = 0.62; specificity = 0.75). For the highest quartile of functioning scores, the optimal differentiating cut-off for age of psychosis onset was 14.7 years (sensitivity = 0.71; specificity = 0.70). Conclusions: Larger samples of patients, assessed at presentation and followed-up, are necessary to clearly examine clinical presentation and outcome as a function of social and neural development to better understand if the differentiation between VEOP and EOP is justified. This will aid the development of predictive diagnostic tools, more accurate prognosis prediction, and age-tailored therapeutic interventions.

AB - © 2015 Elsevier B.V..Objective: It remains unclear whether very early onset psychosis (VEOP; ≤ 12 years of age) and early onset psychosis (EOP; onset 13-17 years of age) are homogeneous in their clinical presentation. We investigated the predictive value of age of psychosis onset for severity, functioning and demographic variation by: 1) comparing groups based on traditional cut-offs for age of psychosis onset, and 2) using receiver operating characteristic (ROC)-curve calculations, without a priori age of onset cut-offs. Method: Participants were 88 (45 female, 43 male) children and adolescents with a recent onset of psychosis (age range = 6.7-17.5 years; M = 13.74, SD = 2.37). Results: The VEOP group had significantly shorter duration of untreated illness and untreated psychosis, and lower functioning than the EOP group. The VEOP and EOP groups did not differ significantly on gender proportion, urbanicity, psychotic diagnosis, family history of psychotic disorder, psychotic, depressive and anxiety symptoms or IQ. When applying ROC-curves to the lowest three quartiles of positive psychotic symptoms scores, the optimal age-cut-off was 14.0 years (sensitivity = 0.62; specificity = 0.75). For the highest quartile of functioning scores, the optimal differentiating cut-off for age of psychosis onset was 14.7 years (sensitivity = 0.71; specificity = 0.70). Conclusions: Larger samples of patients, assessed at presentation and followed-up, are necessary to clearly examine clinical presentation and outcome as a function of social and neural development to better understand if the differentiation between VEOP and EOP is justified. This will aid the development of predictive diagnostic tools, more accurate prognosis prediction, and age-tailored therapeutic interventions.

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DO - 10.1016/j.schres.2015.11.020

M3 - Article

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SP - 211

EP - 216

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

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