HMPAO spect identifies schizophrenic patients with stimulant abuse

tors or prodromal syndromes for psychosis. To address this issue, the authors examined differences in age of onset of principal and comorbid syndromes in fwst-episode psychosis. Methods: Patients were recruited from inpatient and outpatient treatment sites and were age 12 and older, presented with psychotic symptoms, no prior hospitalizations, and minimal or no prior treatment. All diagnoses were made using the SCID-P with high interrater reliability (kappa>0.90). The SCID-P hierarchy was maintained for the principal psychotic disorder diagnosis, but not for comorbid diagnoses. Age of onset was defined as that time when patients endorsed enough symptoms to meet DSM-III-R syndrome criteria for a diagnosis and was also obtained with high interrater reliability (ICC>0.90). Results: Seventy-one patients were recruited during a one year period including 39 with bipolar disorder, 14 with schizophrenia spectrum disorders, i 4 with psychotic depression and 4 with other psychoses. Comorbidity was present in 70% of patients and was significantly more common in patients with affective psychoses (p-0.005). Comorbid eating disorders were observed in bipolar patients only (p,.0.03) and impulse control disorders were observed only in affective psychoses (p-0.03). The age of onset of substance abuse (p~.0001), impulse control (pc0.0001), eating (p,.0.04) and anxiety (p-0.007) disorders all significantly predated the onset of the principal psychotic disorder. Conclusions: Certain types of comorbidity are associated with specific psychotic disorders and the earlier ages of onset of these comorbid syndromes suggest they represent risk factors or prodromal syndromes for the psychotic disorder. At the time of this presentation, we will provide updated information from our ongoing study (N-110-120).