[Retrospective analysis of the course of psychotic episodes in adolescent inpatients]

AIM

Analysis of clinical presentations and course of psychotic episodes in adolescent inpatients.

METHOD

A retrospective analysis of charts of all (n = 300) hospitalised patients diagnosed with of one of the schizophrenia-spectrum disorders (F20-F29) over a 10-year span period (1998-2008) was conducted at the Child and Adolescent Department of Institute of Psychiatry and Neurology. The distribution of diagnoses was compared with a sample of 200 adult hospitalisations. Also, the demographic and clinical data, percentage of rehospitalisations and stability of the diagnosis was analysed.

RESULTS

The distribution of diagnoses in the schizophrenia spectrum of psychotic episodes was found to be different in adolescent patients than in adults. In further analysis of schizophrenia (F20), schizotypal disorder (F21), acute and transient psychotic disorder (F23) and schizoaffective disorder (F25) significant differences in the length of hospitalisation, gender distribution, frequency of rehospitalisation and stability of the diagnosis were observed. Stability of the diagnosis in the whole group was 52%. Schizophrenia was the most stable diagnosis.

CONCLUSION

Distribution of schizophrenia spectrum diagnoses is different in adolescent and adult inpatients. In adolescents psychotic episodes other then schizophrenia are frequent. Diagnostic difficulties seemed to be confirmed by not very high diagnostic stability. However for F20, F21, F23 and F25 diagnoses different clinical and demographic profiles were observed, what may confirm that these disorders are separate nosological entities.

[Retrospective analysis of psychopathological presentation of psychotic episodes in adolescent inpatients]

AIM

Analysis of a clinical presentation and course of psychotic episodes in adolescent inpatients.

METHOD

A retrospective analysis of charts of all (n=104) inpatients diagnosed with one of the schizophrenia-spectrum disorders (schizophrenia, schizotypal disorder and acute and transient psychotic disorders: F20, F21 and F23 according to ICD-10) and assessed with the Positive and Negative Syndrome Scale (PANSS) over a 10-year period (1998-2008) in the Child and Adolescent Psychiatry Department. A psychopathological profile of different disorders and correlation between symptoms and demographic and clinical data were analysed.

RESULTS

Severity of symptoms correlated with length of hospitalisation. In schizophrenia higher PANSS total score and more severe some general symptoms then in schizotypal disorders were observed. Also in schizophrenia more negative symptoms then in acute and transient psychotic disorders were detected. In all three disorders, the psychopathological profile included negative symptoms.

CONCLUSION

In schizophrenia psychopathological symptoms were more severe than in other disorders. Presence of negative symptoms may indicate that all schizophrenia spectrum disorders may have a neurodevelopmental component.

[Vascular ischemic dementia]

Observations are reported of the course and other interrelations between clinical pattern and computer tomography results in 36 patients with vascular ischaemic dementia. Attention is called to the frequency of transient dementia-like disturbances following stroke and to the importance of the middle gyrus of the left frontal lobe in the development of dementia manifestations. In cases with slow progression of dementia symptoms and only scant neurological signs not infrequently long-standing improvement or even complete remission of dementia symptoms occur which sets them apart from mixed forms of dementia. The problem of the occurrence of isolated dementia syndromes of sudden onset is discussed and for them the term "stroke with dementia" is proposed.