2200例重性精神疾病患者出院信息分析

目的分析六类重性精神疾病患者及有两害行为的其他精神疾病患者的出院信息特征,为社区防治提供参考。方法选择2015年3月-8月在首都医科大学附属北京安定医院出院的所有符合《国际疾病分类(第10版)》(ICD-10)精神障碍诊断标准的六类重性精神疾病患者及有两害行为的其他精神障碍患者,对患者出院时医生填写的严重精神障碍患者出院信息单进行分析。结果 1该院出院的重性精神疾病患者以双相情感障碍和精神分裂症为主,分别占47.55%、43.00%。2存在两害行为的重性精神疾病患者占52.73%,两害行为发生率男性高于女性(P0.01)。3精神分裂症和双相情感障碍患者平均住院时间差异有统计学意义(Z=9.907,P0.01)。精神分裂症和双相情感障碍患者起病年龄在14~25岁的分别占57.19%、52.77%,住院次数≥2次的分别占67.55%、64.25%,病程≥5年的分别占64.38%、60.33%。结论 1双相情感障碍和精神分裂症是重性精神疾病防治的重点。2双相情感障碍和精神分裂症患者起病年龄早,住院次数多,病程长,两害行为发生比例高。     

住院精神疾病患者日常生活能力的转归

目的:探讨住院精神疾病患者日常生活能力(ADL)的转归。方法:回顾性分析2015年北京回龙观医院出院的所有精神分裂症、双相障碍和抑郁症患者人口学及临床资料;比较各组患者中文版Barthel指数(MBI-C)入院时和出院时变化。结果:精神分裂症组、双相障碍组和抑郁症组各有1 966例、448例及334例患者入组; 3组间性别、年龄、婚姻状态、住院时间比较差异有统计学意义,双相障碍组平均年龄明显小于其他两组;抑郁症组女性比例明显高于其他两组;精神分裂症组婚姻状态中未婚和离异比例明显高于其他两组,住院时间显著长于其他两组。入院时MBI-C评分3组间差异无统计学意义(F=1. 55,P=0. 213);出院时MBI-C评分及其差值3组间差异有统计学意义(F=20. 32,F=16. 31; P均0. 001);精神分裂症组出院时MBI-C评分及其差值明显低于双相障碍组及抑郁症组(P均0. 001),住院时间峰值(79 d)明显多于双相障碍组(23 d)和抑郁症组(15 d)。结论:与精神分裂症患者相比,双相障碍和抑郁症患者能在更少的住院时间内获得更好的ADL转归。     

住院双相障碍与精神分裂症患者代谢相关障碍的对照研究

目的 了解双相障碍住院患者的肥胖与代谢相关障碍,并与精神分裂症住院患者作一比较.方法 对上海市精神卫生中心分部2008年7月住院期间的双相障碍患者作调查,测定其身高、体重及各代谢指标,用世界糖尿病联盟全球统一标准(IDF)定义代谢综合征及中心性肥胖.随机选取同期住院的两个病房的精神分裂症患者作为比较.结果 共入组双相障碍患者30例,精神分裂症160例.代谢综合征的患病率均较高,肥胖与代谢相关指标如血压、血糖、血脂方面,双相障碍患者与精神分裂症患者的患病率均无统计学差异(P>0.05).二组的超重、高甘油三酯、低HDL及中心性肥胖的比例均明显增高(P>0.05).结论 在住院的双相障碍及精神分裂症患者中同样存在较多代谢相关障碍,需要政策层面的关注.     

住院老年精神疾病患者的现状调查

目的:对住院老年精神疾病患者的现状进行调查。方法:采用回顾性调查法和整群抽样法,收集四川省5所精神专科医院2013年5月至2013年10月住院的所有老年精神疾病患者的病历记录及一般人口学资料进行统计分析。结果:870例有效数据中,老年精神疾病患病率前3位依次为精神分裂症、器质性精神障碍及抑郁症;男性和女性的抑郁症、物质所致精神障碍、神经症的患病率差异有统计学意义(χ~2=41.142,P0.05);农村与城市在精神分裂症、器质性精神病、躁狂症、神经症及双相障碍的患病率分布差异有统计学意义(χ~2=78.435,P0.05)。Logistic回归分析显示,年龄(OR=1.037,P=0.001)和治疗方式(OR=0.252,P=0.000)对疗效影响显著。结论:住院老年精神疾病患者以农村、女性老人为多;综合治疗效果优于单纯药物治疗。     

首发精神疾病患者性激素水平的横断面比较

目的 比较常见首发精神疾病基线期性激素水平的差异.方法 回顾性调查2012年1月至2017年12月在苏州市广济医院住院的514例首发精神疾病患者,其中精神分裂症患者226例,双相情感障碍患者90例,抑郁症患者198例,收集人口学资料及基线期各组患者的黄体生成素(LH2)、卵泡刺激素(FSH)、泌乳素(PRL)、雌二醇(...     

上海市民政系统精神病院住院的精神疾病患者共病躯体疾病分析

目的:了解上海市民政系统精神病医院住院慢性精神疾病患者共病躯体疾病状况。方法:采用自制《病例收集表》调查上海市民政系统精神病医院住院的所有精神疾病患者合并躯体疾病情况及影响因素。结果:1 707例患者中900例(52.7%)共病躯体疾病;前6位依次为高血压病(349例,20.5%)、糖尿病(204例,12.0%)、贫血(145例,8.5%)、心律失常(141例,8.3%)、白细胞减少症(131例,7.7%)及冠心病(120例,7.0%);共病躯体疾病1种600例(35.2%),2种228例(17.0%),≥3种72例(4.2%);共病率随患者年龄及住院时间增加显著增高(P0.01或P0.05)。服用抗精神病药患者糖尿病和心律失常的共病率明显高于未服药患者(P0.05或P0.01);服用第二代抗精神病药患者心律失常和冠心病共病率明显高于服用第一代药患者,白细胞减少发生率明显低于服用一代药患者(P均0.05);联合用药患者心律失常及冠心病发生率明显高于单一用药者(P0.01或P0.05);躯体疾病共病为因变量的回归分析显示患者年龄及服用抗精神病药数量进入模型(P均0.01)。结论:民政系统长期住院的慢性精神疾病患者躯体疾病共病率高,以高血压病、糖尿病、贫血、心律失常和白细胞减少症常见;年龄及服用抗精神病药数量是其影响因素;对共病躯体疾病的患者更应单一用药。     

住院未成年精神疾病患者抗精神病药物使用情况调查

目的调查2018年广州医科大学附属脑科医院住院未成年精神疾病患者抗精神病药物使用情况。方法通过电子住院信息系统收集2018年广州医科大学附属脑科医院所有住院年龄≤18岁且确诊为精神疾病的患者的临床、人口学和出院当日使用抗精神病药物情况,进行统计和分析。结果共入组626例未成年精神疾病患者,出院时93例(14.9%)患者未使用抗精神病药物,92例(14.7%)患者接受两种抗精神病药物联合治疗,441例(70.4%)患者使用一种抗精神病药物治疗;双相障碍(233例)、抑郁症(124例)、精神分裂症(108例)是诊断频率最高的三种精神疾病,其抗精神病药物使用率为别为94.0%、74.2%和99.1%。使用频率最高五种抗精神病药物依次为喹硫平、奥氮平、阿立哌唑、利培酮和帕利哌酮;双相障碍和抑郁症使用频率最高的抗精神病药物为喹硫平,精神分裂症最常使用奥氮平;儿童组患者最常使用阿立哌唑,青少年组患者最常使用喹硫平;男性患者最常使用奥氮平,女性患者最常使用喹硫平。儿童组患者阿立哌唑、利培酮和喹硫平剂量显著低于青少年组,男女两组间抗精神病药物剂量无显著差异。结论大部分住院未成年精神疾病患者在出院时接受单种抗精神病药物治疗,不同诊断抗精神病药物使用种类不同,不同年龄组抗精神病药物使用种类、剂量不同。     

精神疾病患者的血清甲状腺素水平测定结果

为了解精神疾病与甲状腺功能之间的关系 ,我们对 14 8例精神疾病患者的血清甲状腺激素 (ＴＨ )水平进行了测定与分析 ,现将结果报告如下。1　资料与方法1 1　资料　病例组 :住院精神疾病患者共 14 8例(男 70例 ,女 78例 )。①情感性精神障碍 (ＡＤ)组 4 4例 ,平均年龄 (32 2± 7 7)岁 ,其中抑郁发作 (ＤＥ)组2 0例 (单次抑郁发作 5例 ,反复抑郁发作 6例 ,双相情感障碍抑郁发作 9例 ) ,躁狂发作 (ＭＥ)组 2 4例(单次躁狂发作 3例 ,反复躁狂发作 6例 ,双相情感障碍躁狂发作 15例 ) ;②精神分裂症 (ＳＰ)组 86例 ,平均年龄 (33 5± 8 1)岁 ,其…     

2013年荆门市重性精神疾病患者流行病学现状分析

目的 了解荆门市重性精神疾病患者的流行病学分布、生活状态、就医情况及影响因素,为开展公共卫生服务、社区防治工作提供依据.方法 以ICD-10和CCMD-3为诊断标准,向各乡镇卫生院、社区卫生服务中心下发统一的线索调查表,由精神科专业医生对可疑患者进行复核确诊,对2010~2013年纳入国家管理系统的重性精神疾病患者信息进行核对和整理,导出信息并与调查数据进行比较分析.结果 2010~2013年全市共管理重性精神疾病患者9612例,检出率为3.34‰;以精神分裂症(76.77%)为主,检出率为1.99‰;男女比例为1:1.125;患者以18~44岁的青壮年(54.23%)为主;婚姻状况以已婚(55.33%)为主;经济状况以贫困(63.31%)为主;文化程度以文盲(24.15%),小学(31.42%),初中(34.16%)为主;职业以农民(76.51%)及无业(20.89%)为主;病程多在10年以上;精神发育迟滞伴发精神障碍患者住院及治疗比例最低(28.78%);躯体疾病及并发症(66.15%)和意外事故(28.46%)为患者的主要死亡因素.结论 精神分裂症、精神发育迟滞伴精神障碍、双相(情感)障碍患者居荆门市重性精神疾病前3位,女性多于男性,年龄集中在18~45岁,已婚比例低,离婚及丧偶比例高,文化程度低,患者经济负担重,病情迁延,治疗负担重,建议加强和完善各级防治网络建设及社区精神卫生服务,加强重性精神疾病患者的管理,加大政府及公益资金投入.     

双相情感障碍在门诊的误诊情况分析（英文）

背景:双相情感障碍是一种高误诊率的精神疾病,常被误诊为抑郁症、精神分裂症、焦虑症、强迫症和人格障碍等精神疾病,导致临床症状不能有效控制,病情呈反复发作趋势,故近年来双相情感障碍的误诊问题越来越引起精神科医生的重视。目的:了解双相情感障碍在门诊的误诊情况,并分析其误诊原因,指导临床医师加强对双相情感障碍的识别,尽量避免或减少其误诊和漏诊。方法:纳入专家门诊确诊为双相情感障碍的患者,了解其在门诊的就诊及误诊和漏诊情况,通过比较误诊组(包含漏诊者)和确诊组的临床资料进一步分析导致误诊和漏诊的可能原因。结果:双相情感障碍在专家门诊就诊患者中占31.5%。符合本研究入组标准的共有177例,其中误诊组136例(76.8%),确诊组41例(23.2%),误诊为抑郁症者最多(70.6%)。误诊组患者首次发作更多的表现为抑郁发作(χ~2=5.206,p=0.023),并且病程中抑郁发作次数更多(Z=-2.268,p=0.023);误诊组起病至首次治疗的时间较短(Z=-2.612,p=0.009)、而起病至确诊时间更长(Z=-3.685,p0.001),总病程更长(Z=-3.274,p=0.001),并且住院治疗的患者更多(χ~2=4.539,p=0.033),住院次数也更多(Z=-2.164,p=0.031);误诊组伴有精神病性症状更多(χ~2=11.74,p=0.001),尤其抑郁发作时(χ~2=7.63,p=0.006),共病的发生率更高(χ~2=5.23,p=0.022);误诊组HCL-32评分更低(t=-2.564,p=0.011)。误诊组诊断为其他特定的双相及相关障碍的患者较确诊组多(11.0%v.4.9%),并且误诊组最近发作情况表现为抑郁发作的患者较多(78.7%v.65.9%)。结论:门诊双相情感障碍患者的误诊率高,常被误诊为抑郁症。误诊组患者首次发作更多的表现为抑郁发作,病程中抑郁发作次数更多,伴有精神病性症状更多,共病的发生率更高,并且患者对自身躁狂或轻躁狂发作情况明显认识不足,导致早期难以明确诊断,确诊所需时间更长,住院比率更高,住院次数更多。临床医生应提高对双相情感障碍的识别,避免或减少双相情感障碍的误诊和漏诊。     

Major mental disorders and criminal violence in a Danish birth cohort

BACKGROUND: This epidemiological investigation was designed to examine the relationships between each of the major mental disorders and criminal violence. Specifically, we assessed whether a significant relationship exists between violence and hospitalization for a major mental disorder, and whether this relationship differs for schizophrenia, affective psychoses, and organic brain syndromes. METHODS: Subjects were drawn from a birth cohort of all individuals born between January 1, 1944, and December 31, 1947, in Denmark (N = 358 180). Because of the existence of accurate and complete national registers, data were available on all arrests for violence and all hospitalizations for mental illness that occurred for individuals in this cohort through the age of 44 years. RESULTS: There was a significant positive relationship between the major mental disorders that led to hospitalization and criminal violence (odds ratios 2.0-8.8 for men and 3.9-23.2 for women). Persons hospitalized for a major mental disorder were responsible for a disproportionate percentage of violence committed by the members of the birth cohort. Men with organic psychoses and both men and women with schizophrenia were significantly more likely to be arrested for criminal violence than were persons who had never been hospitalized, even when controlling for demographic factors, substance abuse, and personality disorders. CONCLUSIONS: Individuals hospitalized for schizophrenia and men hospitalized with organic psychosis have higher rates of arrests for violence than those never hospitalized. This relationship cannot be fully explained by demographic factors or comorbid substance abuse.     

Psychosis in a pediatric mood and anxiety disorders clinic: phenomenology and correlates

OBJECTIVES: To examine the demographics and phenomenology of psychosis in a sample of children and adolescents referred to a mood and anxiety disorders clinic. METHOD: Patients (N = 2,031) were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode version and classified as definite, probable, or nonpsychotic. Clinical and demographic characteristics of the groups were compared,and symptoms of psychosis were analyzed using factor analysis. RESULTS: Definite psychotic symptoms were seen in approximately 90 (4.5%) patients: 80% of these reported hallucinations (mainly auditory), 22% delusions, and 3.3% thought disorder. Of the patients with definite psychotic symptoms, 24% had bipolar disorder, 41% had major depression, 21% had subsyndromal depression, and 14% had schizophrenia spectrum disorders (schizophrenia and schizoaffective disorders). Factor analysis of the definite psychotic symptoms yielded 4 factors: hallucinations, thought disorder, delusions, and manic thought disorder. Psychotic patients had a higher frequency of comorbid disorders and suicidal ideation than nonpsychotic patients. CONCLUSIONS: Outpatient youngsters with mood disorders frequently present with psychotic symptoms, in particular auditory hallucinations. These patients commonly have comorbid psychiatric disorders and suicidal ideation.     

Comorbid disorders in hospitalized bipolar adolescents compared with unipolar depressed adolescents

This study examined comorbid psychiatric disorders in adolescents with bipolar disorder. Hospitalized bipolar adolescents (N=10) were compared to hospitalized adolescents with unipolar depression (N=33), and to adolescents with nonaffective psychiatric disorders (N=11). Results showed conduct disorder, attention-deficit hyperactivity disorder, psychosis, and having any DSM-III-R psychoactive substance use disorder were all significantly more common in the bipolar group than the unipolar depressed group. Comorbid anxiety disorder was present in 40–45% of the subjects in the unipolar and bipolar groups, but in none of the control group subjects. This study is supported in part by a grant to Dr. Borchardt from the University of Minnesota Graduate School.     

Neurocognitive Dysfunction in Bipolar and Schizophrenia Spectrum Disorders Depends on History of Psychosis Rather Than Diagnostic Group

Objectives: Neurocognitive dysfunction is milder in bipolar disorders than in schizophrenia spectrum disorders, supporting a dimensional approach to severe mental disorders. The aim of this study was to investigate the role of lifetime history of psychosis for neurocognitive functioning across these disorders. We asked whether neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends more on history of psychosis than diagnostic category or subtype. Methods: A sample of individuals with schizophrenia (n = 102), schizoaffective disorder (n = 27), and bipolar disorder (I or II) with history of psychosis (n = 75) and without history of psychosis (n = 61) and healthy controls (n = 280), from a large ongoing study on severe mental disorder, were included. Neurocognitive function was measured with a comprehensive neuropsychological test battery. Results: Compared with controls, all 3 groups with a history of psychosis performed poorer across neurocognitive measures, while the bipolar group without a history of psychosis was only impaired on a measure of processing speed. The groups with a history of psychosis did not differ from each other but performed poorer than the group without a history of psychosis on a number of neurocognitive measures. These neurocognitive group differences were of a magnitude expected to have clinical significance. In the bipolar sample, history of psychosis explained more of the neurocognitive variance than bipolar diagnostic subtype. Conclusions: Our findings suggest that neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders is determined more by history of psychosis than by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnostic category or subtype, supporting a more dimensional approach in future diagnostic systems.     

Neurodevelopmental Pathways in Schizophrenia

We examined early-onset schizophrenia as a neurodevelopmental disorder. These data are from a 2-year longitudinal prospective study of youth with psychotic disorders. Standardized diagnostic and neuropsychological assessments include: Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV; Diagnostic Interview for Children and Adolescents, Revised; Premorbid Adjustment Scale; Wechsler Intelligence Scale for Children-III; the Wisconsin Card Sorting Test (WCST), and the California Verbal Learning Test. Pertinent family and developmental history are obtained via parent interviews and chart review. Forty-eight subjects have been recruited to date; 17 with schizophrenia, 13 with bipolar disorder, 10 with psychosis nos, seven with schizoaffective disorder, and one with an organic psychosis. Subjects with schizophrenia had higher ratings of premorbid social withdrawal and dysfunctional peer relationships. All groups had high rates of cognitive impairment, prenatal/perinatal complications, and comorbid psychiatric disorders. Homotypic family psychiatric history was associated with diagnosis in youth. Our data are consistent with a neurodevelopmental model, whereby specific genetic/neurological risk factors and nonspecific biologic/environmental modulating factors interact in the development of schizophrenia and other psychotic disorders.     

Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis

OBJECTIVE: To examine and compare the adult outcome in a representative sample of hospitalized adolescent-onset psychoses including occupational and social aspects. METHOD: A total of 81 patients with a first episode of early-onset psychosis (before age 19 years) presenting to the University Hospital of Lund, Sweden, between 1982 and 1993 were followed up an average of 10.5 years (range 5.1-18.2) after admission. Initial diagnosis was assessed from records and consisted of DSM-IV schizophrenia (n = 32), schizoaffective disorder (n = 7), bipolar disorder (n = 25), and major depressive disorder with psychotic features (n = 17). All could be traced and assigned a major outcome group. RESULTS: Early-onset schizophrenia spectrum disorder suffered a chronic course with a poor outcome in 79% of the cases, while early-onset affective psychosis in 74% showed a good or intermediate outcome. The poor outcome (26%) in the affective group was connected to mental retardation in 7% and to progression to a schizoaffective disorder in 12%. A particularly severe outcome was seen for schizophrenia spectrum patients with a family history of nonaffective psychosis. CONCLUSIONS: Early-onset schizophrenia spectrum disorder showed a severe course while affective psychoses had a much more benign functional outcome.     

Obsessive-compulsive and panic symptoms in patients with first-admission psychosis

OBJECTIVE: The occurrence, persistence and specificity of the association between comorbid obsessive-compulsive and panic symptoms and three psychotic disorders--schizophrenia/schizoaffective disorder, bipolar disorder with psychosis, and major depression with psychosis--were examined in a first-admission, epidemiologically defined group of patients with psychotic symptoms. METHOD: The Structured Clinical Interview for DSM-III-R obsessive-compulsive and panic modules were administered at baseline and 24-month follow-up to patients with schizophrenia/schizoaffective disorder (N=225), bipolar disorder with psychosis (N=138), and major depression with psychosis (N=87) participating in the Suffolk County (N.Y.) Mental Health Project. The rates of subsyndromal symptoms and disorder criteria met were compared across the three psychosis groups. Recognition and treatment of anxiety symptoms at initial discharge and impact of the baseline presence of anxiety symptoms on 24-month clinical status were also examined. RESULTS: Obsessive-compulsive and panic symptoms were present at baseline in 10%-20% of all three groups. There was no specific association between obsessive-compulsive symptoms and any specific psychosis diagnosis; however, women with major depression with psychosis had a significantly higher rate of panic symptoms than the other two groups, and schizophrenia/schizoaffective disorder patients with baseline panic symptoms were significantly more likely to exhibit positive symptoms of psychosis after 24 months. CONCLUSIONS: The authors found no specific association between obsessive-compulsive symptoms and diagnosis early in the illness course, but the finding of an association between panic symptoms and psychotic depression among female patients and between baseline panic and positive psychotic symptoms in schizophrenia/schizoaffective disorder patients at 24 months suggests the need for further study.     

Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda

While psychiatric and physical comorbidities in severe mental illness (SMI) have been associated with increased mortality and poor clinical outcomes, problem has received little attention in low- and middle-income countries (LMICs). This study established the prevalence of psychiatric (schizophrenia, bipolar affective disorder, and recurrent major depressive disorder) and physical (HIV/AIDS, syphilis, hypertension and obesity) comorbidities and associated factors among 1201 out-patients with SMI (schizophrenia, depression and bipolar affective disorder) attending care at two hospitals in Uganda. Participants completed an assessment battery including structured, standardised and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidities and potential risk factors. Bipolar affective disorder was the most prevalent (66.4%) psychiatric diagnoses followed by schizophrenia (26.6%) and recurrent major depressive disorder (7.0%). Prevalence of psychiatric comorbidity was 9.1%, while physical disorder comorbidity was 42.6%. Specific comorbid physical disorders were hypertension (27.1%), obesity (13.8%), HIV/AIDS (8.2%) and syphilis (4.8%). Potentially modifiable factors independently significantly associated with psychiatric and physical comorbidities were: use of alcohol for both syphilis and hypertension comorbidities; and use of a mood stabilisers and khat in comorbidity with obesity. Only psychiatric comorbidity was positively associated with the negative outcomes of suicidality and risky sexual behaviour. The healthcare models for psychiatric care in LMICs such as Uganda should be optimised to address the high burden of psychiatric and physical comorbidities.

     

Low anxiety disorder comorbidity rate in bipolar disorders in Han Chinese in Taiwan

Objectives

Studies report high comorbidity of lifetime anxiety disorders with bipolar disorders in Western patients, but it is unclear in Taiwan. The authors explored the comorbidity of anxiety disorders in different bipolar disorder subtypes in Han Chinese in Taiwan.

Methods

Three hundred twenty-five patients with bipolar disorder (bipolar I: 120; bipolar II: 205) disorder were recruited from two general medical outpatient services. They were evaluated and their diagnoses confirmed by a psychiatrist using the Chinese version of the Modified Schedule of Affective Disorder and Schizophrenia-Lifetime. The exclusion criteria were: any DSM-IV-TR Axis I diagnosis, other than bipolar disorder, being outside the 18-65-year-old age range, any other major and minor mental illnesses except anxiety disorder, any neurological disorders or organic mental disorders.

Results

Thirty-two (26.7%) of patients were comorbid with lifetime anxiety disorder and bipolar I, 80 (39.0%) with lifetime anxiety disorder and bipolar II, 7 (5.8%) were comorbid with two or more anxiety disorders and bipolar I, and 27 (13.2%) with two or more anxiety disorders and bipolar II.

Conclusion

That more than twice as many bipolar II than bipolar I patients reported two or more anxiety disorders implies that the complication is more prevalent in bipolar II patients.     

Early onset psychotic disorders: Diagnostic stability and clinical characteristics

To examine the clinical features and diagnostic stability of early-onset psychotic disorders. These data are from a two-year longitudinal prospective study of youth with psychotic disorders. Standardized diagnostic assessments are administered at baseline and at one and two-year’s follow-up. Fifty-one subjects have been recruited to date; 18 with schizophrenia, 14 with bipolar disorder, 7 with schizoaffective disorder, 1 with an organic psychosis, and 11 subjects whose symptoms where either questionable and/or did not meet diagnostic criteria for another disorder (classified as psychosis nos). Thirty-nine subjects were reassessed at year one, twenty-four at year two. Three subjects have been lost to follow-up. The study diagnosis was the same as the first onset diagnosis (prior to entering the study) in 50% of subjects. Over the two-year period of the study, the diagnosis remained unchanged in over 90% of subjects. Subjects with schizophrenia had higher ratings of premorbid impairment, including social withdrawal and dysfunctional peer relationships, than those with bipolar disorder. At the one-year follow-up, subjects with schizophrenia and schizoaffective disorder had significantly higher rates of delusions, bizarre behavior, and negative symptoms than those with bipolar disorder. Subjects with bipolar disorder tended to have cyclical courses, whereas those with schizophrenia and schizoaffective disorder were often chronically impaired. Subjects with psychosis nos had higher rates of dissociative symptoms and histories of child maltreatment Early-onset psychotic disorders can be reliably diagnosed using standardized assessments and are stable over a two-year period. Compared to bipolar disorder, schizophrenia is associated with a poorer premorbid history, and persistent positive and negative symptoms.