The role of age in the development of Schneiderian symptoms in patients with a first psychotic episode.

Objective:  The likelihood of developing psychotic symptoms greatly increases after puberty. In acute psychotic disorders, first rank symptoms (FRS) are prevalent and considered useful for the diagnostic process. The aim of this study was to test for a linear association between age and the probability of occurrence of FRS in patients with a first psychotic episode (FPE). Method:  A total of 112 patients, consecutively admitted with an FPE, were included at baseline and evaluated yearly over a 3-year period using SCID-I and a checklist of 11 items of FRS. Results:  FRS were documented for 65.2% patients at baseline. There was a dose–response relationship in the association between age and FRS. There was no interaction with sex or with final diagnostic category. Conclusion:  Variation in the expression of the core positive symptoms of psychosis is subject to the influence of underlying age-dependent maturational processes both in terms of occurrence and level of severity.