Adolescent Onset Psychosis: A 2-year retrospective study of adolescents admitted to a general psychiatric unit

Abstract

Background:KwaZulu-Natal had no dedicated in-patient adolescent psychiatric service during the study period and adolescents were admitted to general psychiatric wards.

Aim of Study: This is a descriptive review of adolescents admitted with psychotic symptoms to a psychiatric hospital. It aims to describe their demographic profile, associated risk factors, clinical profile and management strategies utilized.

Method: The files of all adolescent patients with psychotic symptoms, aged twelve to eighteen years old, admitted to a psychiatric hospital from July 2005 to June 2007 were reviewed.

Results: 70 adolescents with psychosis were admitted to adult psychiatric wards over the 2 year period. The age range was 13 to 18 years old. 80% of the adolescent patients were male, 37% reported a positive family history of mental illness, 50% smoked nicotine and 61.4% reported cannabis use. The most common diagnoses were schizophrenia (30%) and schizophreniform disorder (27.1%). 85.5%(60) of adolescent patients had a trial on a first generation antipsychotic and 10 patients were initiated on a second generation antipsychotic de- novo. The average length of stay in hospital was 27.8 days. 40% defaulted follow up post discharge.

Conclusion: Schizophrenia was the most common diagnosis. There were high rates of cannabis use. The adolescents were managed in psychiatric wards for significant periods and the majority of patients were initiated on first-generation antipsychotics. There is a need to develop specialized inpatient adolescent psychiatric facilities and services, as well as to address the issues of co-morbid substance use and non-adherence to treatment.