Clinical correlates of first episode early onset psychosis in KwaZulu-Natal, South Africa

AbstractBackgroundEarly identification is important for patients with early-onset schizophrenia (SZ). Assessment of (candidate) endophenotypic markers for SZ, such as prepulse inhibition of the startle reflex (PPI), may help distinguish between the early-onset SZ and other psychiatric disorders. We explored whether PPI deficits usually seen in adult-onset SZ are present in young adolescents with either early-onset psychosis or attention deficit/hyperactivity disorder (ADHD).MethodsTwenty-five adolescents with first-episode, non-affective psychosis (FEP), 28 adolescents with ADHD and 43 healthy controls (HC), aged 12–17 years, were assessed with an auditory PPI paradigm.ResultsNo significant group differences were found in PPI. However, when the FEP group was divided into those already diagnosed with SZ (n = 13) and those without (N-SZ) (n = 12), and all four groups (SZ, N-SZ, ADHD and HC) were compared on percentage PPI in the 85/60 trials, significantly less PPI was found in patients with SZ than in the HC as well as the ADHD group. No significant group differences were found in explorative analyses on the other trial types. Additionally, startle magnitude was significantly higher in SZ than in N-SZ patients.ConclusionYoung adolescents with SZ showed sensorimotor gating deficits similar to those usually found in adults with SZ and had larger startle magnitude than patients with other types of non-affective early-onset psychosis. No sensorimotor gating deficits were found in adolescents with ADHD. Our findings support the theory that deficient PPI is endophenotypic for SZ.

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Recovery and self-identity development following a first episode of psychosis

Journal of Public Mental Health ◽

10.1108/jpmh-01-2019-0013 ◽

2019 ◽

Vol 18 (3) ◽

pp. 169-179

Author(s):

Nicola Ann Cogan ◽

Matthias Schwannauer ◽

Sean Harper

Keyword(s):

Identity Development ◽

Early Onset ◽

Sense Of Self ◽

Public Mental Health ◽

First Episode ◽

Structured Interviews ◽

Content Type ◽

Self Identity ◽

Early Onset Psychosis ◽

The Impact

Purpose The onset of psychosis typically develops during adolescence, a crucial period for beginning the transition from family to independence and developing a stable sense of self. Recovery amongst adolescents experiencing early onset psychosis has not yet been investigated with reference to its influence on self-identity. The purpose of this paper is to explore the impact living with early onset psychosis has on self-identity for adolescents in recovery. Design/methodology/approach A purposive sample of ten adolescents aged between 16 and 18 years from an Early Intervention Service in the Scottish National Health Service were recruited. All had experienced at least one episode of psychosis and were within three years of first contact with the service. Semi-structured interviews were adopted to capture adolescents’ perspectives concerning their experiences of recovery from psychosis and the impact on self-identity. All interviews were audio-recorded, transcribed and thematically analysed. Findings Qualitative analysis of adolescents’ accounts revealed how recovery from psychosis involves working with individual explanatory frameworks concerning uncertain identities and status ambiguity, a decrease in referent points and unfavourable social comparisons (emphasising loss, grief and self-criticism). Research limitations/implications Supporting adolescents experiencing early psychosis involves education, rebuilding relationships with self and others and providing access to psychotherapeutic interventions to aid self-identity development when needed. Originality/value The originality of this paper lies in the importance of identity, recovery, human reconnection, advocacy and community reintegration for adolescents experiencing psychosis. Public mental health campaigns to tackle the stigma surrounding psychosis are essential to assisting adolescents in developing their sense of self through their recovery journeys.

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