A 45-year follow-up study of adolescent schizophrenia. Part IV : Clinical status and level of social adaptation 5 years after the first hospitalization in the context of illness course and long-term social functioning of patients

Objectives: Research on predictors of adolescent schizophrenia, especially those based on long-term follow-up period, is rare in the literature. In our analysis, we examine the relationship of the clinical status and level of social adaptation 5 years after the first hospitalization with clinical and social indicators of the disease. Methods: 69 patients at the average age of 16 years (time point 0), hospitalized due to schizophrenia (retrospectively re-diagnosed according to ICD-10 criteria) and re-examined 5 years later (time point 1 – personal examination of 41 individuals), were re-evaluated for clinical and social parameters 45 years after their initial hospitalization (time point 2 – personal examination of 21 individuals). In addition to the personal survey, other methods of data collection were used, including hospital queries. Results: The clinical picture of schizophrenia 5 years after the first hospitalization described by the intensity of psychopathology, as well as other parameters of the clinical status (e.g. insight, clinical improvement, relational abilities, GAF), revealed numerous and various correlations both with the symptomatic picture and clinical course of schizophrenia 45 years after the first hospitalization and with distant social functioning of the subjects. In the analyses, high prognostic significance was also revealed by the level of psychotic relapse, the presence of auto-aggressive tendencies, and the quality of school and professional adaptation assessed at time point 1. Conclusions: The level of functioning achieved by the patient in clinical and social areas during the first 5 years after their initial hospitalization proved to be an important prognostic factor in adolescent schizophrenia.