Dysthymia in male adolescents is associated with increased risk of later hospitalization for psychotic disorders: A historical-prospective cohort study

Mark Weiser, Gad Lubin, Asaf Caspi, Jonathan Rabinowitz, Mordechai Shmushkevitz, Rinat Yoffe, Nomi Werbeloff, Demian Halperin, Michael Davidson

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Retrospective studies indicate that patients with psychotic disorders and schizophrenia often suffer from depressive symptoms before the onset of psychosis. In a historical-prospective design, we studied the association between dysthymia in adolescence and later hospitalization for psychotic disorders and schizophrenia. Methods: The Israeli Draft Board screens the entire, unselected population of 16-17 years old male adolescents for psychiatric disorders. These adolescents were followed for hospitalization for psychotic disorders and schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Of 275705 male adolescents screened, 1267 (0.5%) were hospitalized for psychotic disorders (International Classification of Diseases [ICD]-10 20.0-29.9), and 757 (0.3%) were hospitalized for schizophrenia (ICD-10 20.0-20.9) over the next 1-10years. Results: Of 275705 male adolescents screened, 513 (0.2%) were diagnosed as suffering from dysthymia by the Draft Board. Of these adolescents, 10/ 513 (2.0%) were later hospitalized for psychotic disorders (including schizophrenia, HR = 3.967, 95%CI (confidence intervals): 2.129-7.390), and 4/513 (0.8%) were later hospitalized for schizophrenia (HR = 2.664, 95%CI: 0.997-7.116). Conclusions: In this population-based cohort of male adolescents, dysthymia was associated with increased risk for future psychotic disorders. Dysthymia in some adolescents might be a prodromal symptom, while in others it might be a risk factor for later psychosis. Clinicians assessing dysthymic adolescents should be aware that these symptoms might be part of the prodrome.

Original languageEnglish
Pages (from-to)67-72
Number of pages6
JournalEarly Intervention in Psychiatry
Volume2
Issue number2
DOIs
StatePublished - 2008

Keywords

  • Dysthymia
  • Longitudinal
  • Psychotic disorders
  • Risk
  • Schizophrenia

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