On early and mid-adolescent schizophrenia. Part 1: Phenomenological aspects.
One hundred and seventy-three early and mid-adolescent schizophrenic patients were investigated during the 18-year period from April 1958 to March 1976 and the results concerning phenomenological aspects were reported here along with some considerations. 1. Hereditary predispositions were found in 43 cases among 161 patients. Male patients seemed to be more predisposed than female patients. The incidence of schizophrenia was the highest among other mental disorders, while it was most frequently observed in mothers and siblings among other kinships. 2. Precipitative factors were recognized in 45 cases. Among them, primary social factors and physical conditions seemed to play a rather important role. These factors seemed more frequent in males than in females. 3. As to birth order, the incidence of adolescent schizophrenia seemed to be higher in the last half of sibships than in the first half but the difference was significant at a five-percent level when the sibship sizes were 5--9. From the comparison of our results with the national statistics of the birth order in general population, the incidence of adolescent schizophrenia seemed to be lowest in the sublings of the second birth. 4. We divided the onset into three types; acute, intermediate and insidious. We were impressed that the acute onset seemed gradually to increase in mid-adolescence and the insidious onset vice versa. In addition, the insidious onset was found chiefly in cases with hebephrenic pictures except hebe-paranoid. 5. Hebephrenic form and simple form were frequently observed but catatonic form was relatively few. Genuine paranoid form was not found in our materials. Hebephrenic and catatonic forms were more frequently seen in males, while hebe-paranoid form was more frequent in females. 6. Main symptoms at the onset were discussed. Delusional activities, still vague and fragmentary, were observed in about half of our materials, being mostly persecutory. It seemed that they were strongly influenced by the state of mood of patients. Hallucinations, mostly auditory of verbal nature, were observed in more than one-fourth of our patients. On the contrary, the cases with visual and bodily hallucinations were a few in number. Autistic tendency and refusal of scholastic activities were more frequently seen in early adolescence, while suicidal attempts or self-injuring tendency, manic or depressive tinge, "gemachte Erlebnisse", "Eigengeruchsparanoia" were rather prevalent or first observed in mid-adolescence. Various symptoms, in general, seemed to become gradually more prominent along with the progression of ages. 7. EEG findings and treatment were reported at the same time. But the course and the problem of defect will be discussed in another paper. 8. Finally, the summaries of sex differences and of the comparison between early and mid-adolescence were supplemented.