Paranoid schizophrenia in adolescence

Background: Paranoid schizophrenia is considered to be a rare condition in adolescence. Since this is contrary to the authors' clinical experience, they hypothesized that a controlled study would show that a significant number of adolescents would be diagnosed with paranoid schizophrenia and that scores from the childhood version of the Schedule for Affective Disorders and Schizophrenia (K-SADS) would differentiate between the paranoid schizophrenic adolescents and adolescents with other types of schizophrenia or with affective disorder. Method: The authors conducted a prospective study of 120 adolescents admitted consecutively to an adolescent psychiatric inpatient department. Patients were diagnosed on the basis of DSM-III after an 8-week period during which they were evaluated with a structured psychiatric history and psychiatric examination, the K-SADS, repeated nonstructured interviews, and extensive ward observations. Results: Thirty-eight percent of the schizophrenic adolescents and 14% of the total hospitalized population met the DSM-III criteria for paranoid schizophrenia. The symptom profile of the paranoid schizophrenic adolescents clearly distinguished them from adolescents with other psychiatric disorders. Conclusions: Given the incidence of paranoid schizophrenia in an adolescent population, adolescent psychiatrists are likely to encounter this disorder. DSM-III-R should be used in future studies to further clarify the issue of the prevalence of paranoid schizophrenia in adolescents.