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Association Between Nonpsychotic Psychiatric Diagnoses in Adolescent Males and Subsequent Onset of Schizophrenia
Mark Weiser, MD;
Araham Reichenberg, PhD;
Jonathan Rabinowitz, PhD;
Zeev Kaplan, MD;
Mordehai Mark, MD;
Ehud Bodner, PhD;
Daniella Nahon, MA;
Michael Davidson, MD
Arch Gen Psychiatry. 2001;58:959-964.
Background Nonpsychotic psychiatric symptoms may occasionally herald the later
development of schizophrenia. This study followed a population-based cohort
of adolescents with nonpsychotic, non–major affective psychiatric disorders
to ascertain future hospitalization for schizophrenia.
Methods Results of the medical and mental health assessments on 124 244
16- to 17-year-old males screened by the Israeli draft board were cross-linked
with the National Psychiatric Hospitalization case registry, which contains
data on all psychiatric hospitalizations in the country, during a 4- to 8-year-long
follow-up through age 25 years. In the cohort, 9365 adolescents were assigned
a nonpsychotic, non–major affective diagnosis by the draft board.
Results After excluding 167 adolescents who were hospitalized before or up to
1 year after the draft board assessment, 1.03% of the adolescents assigned
a nonpsychotic, non–major affective psychiatric diagnosis, compared
with only 0.23% of the adolescents without any psychiatric diagnosis, were
later hospitalized for schizophrenia. Of the patients with schizophrenia,
26.8%, compared with only 7.4% in the general population, had been assigned
a nonpsychotic, non–major affective psychiatric diagnosis in adolescence
(overall odds ratio [OR], 4.5; 95% confidence interval [CI], 3.6-5.6), ranging
from OR, 21.5 (95% CI, 12.6-36.6) for schizophrenia spectrum personality disorders
to OR, 3.6 (95% CI, 2.1-6.2) for neurosis.
Conclusion These results reflect the relatively common finding of impaired functioning
in patients later hospitalized for schizophrenia and the relatively low power
of these disorders in predicting schizophrenia.
From the Sheba Medical Center, Tel-Hashomer (Drs Weiser, Reichenberg,
and Davidson), Bar Ilan University (Dr Rabinowitz), Division of Mental Health,
Mental Health Department, Medical Corps, Israel Defense Forces (Drs Kaplan,
Mark, and Bodner), and Division of Mental Health, Ministry of Health (Dr Mark
and Ms Nahon), Israel.
Corresponding author and reprints: Michael Davidson, MD, Chaim Sheba
Medical Center, Tel-Aviv University, Tel-Hashomer 52621, Israel (e-mail:
davidso{at}netvision.net.il).
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