Adolescents and Adults Onset of Acute Psychosis: A prospective study of Clinical, Neuroimaging and Short Term Outcome Variables

Abstract

• Acute psychosis is a common psychiatric emergency that may present to health services other than mental health practitioners. Their response to antipsychotic drugs is very good and their outcome. The one-year prevalence of non-organic psychosis is 4.5 per 1000 community residents. Estimation of the prevalence of psychosis is 0.9 per 10, 000 at age 13years, 17.6 per 10, 000 at 18 years. The first episode of a psychotic disorder typically occurs in late adolescence or young adulthood, a critical time of development. • The first few years of psychosis appear to be a critical period especially in late adolescence and early adulthood during which early intervention needs to be initiated before the consequences of psychosis become more severe. • Pervious literatures reported that patients with adolescent onset of psychosis are more likely to present with clinical characteristics that portend a poorer outcome, less adherence for treatment and may require a different approach to early identification and treatment. • There are few imaging studies in adolescent patients with acute psychosis. Most studies on neuroanatomical markers have investigated the role of grey matter and little about white matter (WM). The long lasting development of the WM is paralleled with cognitive, behavioral, emotional, and motor development during childhood and adolescence. This is surprising as loss of WM integrity has been suggested as a key component of psychotic disorders. DTI studies in adolescents with early onset psychosis demonstrate lower anisotropic diffusion within WM due to loss integrity of white matter fiber tracts.