Psychosis in a Developmental Psychopathology Context: A Factor Analytic Study of Schizophrenia in Adolescent Psychiatric Inpatients

Demographic, historical, psychometric, and clinical data were obtained from the psychiatric files of all patients manifesting schizophrenic symptomatology who were hospitalized in an adolescent psychiatric facility during a five year period (N= 71). Factor analysis of the usable data resulted in three interpretable factors, which included: (1) aggressive behavior; (2) disturbed family functioning; and, (3) thought disorder. Age of first hospitalization correlated positively with factor three. The results provide support for concerns expressed by a number of scientists and clinicians that schizophrenia may not be a discrete, unitary disorder; and that uncritical downward extension of adult diagnoses to adolescents and prepubescent children may be questionable. The results further suggest that current DSM-III and DSMIII-R subtypes of schizophrenia (which are clinically derived and symptom based), are not validated by empirically derived subtypes that include objective indices of behavior along with clinical symptoms. The correlation of age of first hospitalization with one of the three factors suggests that developmental level at the onset of illness may represent an important mediating variable in the severity and prognosis of certain subtypes of schizophrenia