Elena Meškauskaitė1, Tomas Lasys2, Dalia Velavičienė2
1Vilnius University Medical Faculty, Vilnius, Lithuania
2Lithuanian University of Health Science, Psychiatric Clinic, Kaunas, Lithuania
Introduction: First time psychotic episodes require careful scrutiny of their possible causes especially diagnosing adolescent. Nowadays there is little information on clinical features of psychosis manifestation in young age.
Aim: To analyse clinical features and risk factors of first episode of psychosis in adolescence age.
Materials and methods: Retrospectively 38 case files of patients who experienced first psychotic episode (ICD-10 diagnosis F23) under age 18 from 2010 to 2014 were examined. After exclusion of patients whose diagnoses changed during hospitalisation, 27 patients case files were examined. Case histories were explored for sociodemographic data and clinical features.
Results: Analysis showed that there was 55.6% man, and 44.4% woman. Mean age 15.50 years. Associated diseases were investigated and comorbid mental disorders were found in 53.6% patients and somatic illness had 21.4% of patients. Mostly patients lived in urban environment 66.7%, in family with both parents 63.0%, and with single parent 37.0%. Mental disorder risk factors were evaluated such as complicated birth 18.5%, head injuries 11.1%, heredity of mental disorders in family 25.9%, psychotrauma 44.4%, past suicidal tendencies: thoughts 3.7%, attempts 11.1%, and present suicidal tendencies – thoughts 29.6%. Substance abuse was found in 37.0% of all patients of those nicotine use 22.2%, alcohol use 25.9%, cannabis use 18.5%. Clinical features were analysed: hallucinations were present at 35.7% of cases. Manifestation of following types of delusions was observed: dysmorphic delusions 7.4%, expansive delusions 11.1%, nihilistic delusion 3.7%, delusions of persecution: 44.4%, relationship delusion 55.6 %, poisoning delusion: 22.2%.
Conclusion: Adolescent patients with first episode of psychosis tend to have risk factors- substance abuse, psychotrauma, heredity, suicidal tendencies. Majority of patients presented with delusions of persecution and relationship as well as poisoning delusion. Hallucinations are less common.