University of Oulu

Immonen J, Jääskeläinen E, Korpela H and Miettunen J. Age at onset and the outcomes of schizophrenia: A systematic review and meta-analysis. Early Intervention in Psychiatry. 2017;11:453–460.

Age at onset and the outcomes of schizophrenia : a systematic review and meta-analysis

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Author: Immonen, Johanna1,2; Jääskeläinen, Erika1,2,3; Korpela, Hanna1,2;
Organizations: 1Center for Life Course Health Research, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
3Oulu Occupational Health, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: John Wiley & Sons, 2017
Publish Date: 2018-01-08


The aim of this study was to analyse the effect of age at onset on the long-term clinical, social and global outcomes of schizophrenia through a systematic review and a meta-analysis. Original studies were searched from Web of Science, PsycINFO, Pubmed and Scopus, as well as manually. Naturalistic studies with at least a 2-year follow-up were included. Of the 3509 search results, 81 articles fulfilled the inclusion criteria. The meta-analysis was performed in Stata as a random-effect analysis with correlation coefficients between age at onset and the outcomes (categorized into remission, relapse, hospitalization, positive symptoms, negative symptoms, total symptoms, general clinical outcome, employment, social/occupational functioning and global outcome). There was a statistically significant (P < .05) correlation between younger age at onset and more hospitalizations (number of studies, n = 9; correlation, r = 0.17; 95% confidence interval, CI 0.09–0.25), more negative symptoms (n = 7; r = 0.14; 95% CI 0.01–0.27), more relapses (n = 3; r = 0.11; 95% CI 0.02–0.20), poorer social/occupational functioning (n = 12; r = 0.15; 95% CI 0.05–0.25) and poorer global outcome (n = 13; r = 0.14; 95% CI 0.07–0.22). Other relationships were not significant. This was the first systematic review of the effects of age at onset on the long-term outcomes of schizophrenia. The results show that age at onset has a small, but significant impact on some of the outcomes of schizophrenia.

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Series: Early intervention in psychiatry
ISSN: 1751-7885
ISSN-E: 1751-7893
ISSN-L: 1751-7885
Volume: 11
Issue: 6
Pages: 453 - 460
DOI: 10.1111/eip.12412
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3124 Neurology and psychiatry
Funding: This work was supported by Academy of Finland (grant numbers 268336 and 278286), NARSAD: The Brain and Behavior Research Foundation, the Sigrid Jusélius Foundation, the Northern Finland Health Care Support Foundation and the European Union’s Horizon 2020 research and innovation programme (grant agreement number 643552).
EU Grant Number: (643552) m-RESIST - Mobile Therapeutic Attention for Patients with Treatment Resistant Schizophrenia
Academy of Finland Grant Number: 268336
Detailed Information: 268336 (Academy of Finland Funding decision)
278286 (Academy of Finland Funding decision)
Copyright information: © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.