THE ONSET OF SCHIZOPHRENIA IN CHILDHOOD AND ADOLESCENCE AS AN UNFAVORABLE PROGNOSTIC INDICATOR (based on the results of an epidemiological study in the socio-economic conditions of the Fergana Valley of the Republic of Uzbekistan)

Abstract

Relevance. Schizophrenia with onset in childhood and adolescence is one of the key unfavorable prognostic factors affecting the course and outcome of the disease. In the Fergana Valley, this problem is particularly relevant due to the high proportion of early onset cases. The aim of the study is to identify the characteristics of early-onset schizophrenia in the Fergana Valley, substantiate its prognostic significance, and establish priorities for early detection and prevention programs. Materials and methods.  A retrospective analysis of 1087 cases of schizophrenia registered in the Fergana Valley between 1984 and 2024 was conducted. Patients were categorized by age of disease onset (under 20 years, 21-29, 30-39, 40 and older). Statistical methods were used to assess the influence of age and associated factors (heredity, exogenous triggers, schizoid premorbid personality) on the course of the disease. Results. Nearly 44% of cases had onset before age 20, a figure that has remained stable over 40 years. Early onset is associated with longer episodes, reduced quality of remission, and deterioration in social adaptation. Hereditary predisposition and schizoid premorbid personality are linked to a more severe course and incomplete remissions, while exogenous factors show a tendency towards improved prognosis. A statistically significant increase in cases with onset between ages 30-39 was noted. Conclusion.  Early onset of schizophrenia is a persistent unfavorable prognostic indicator, necessitating the development of regional programs for early detection and comprehensive psychosocial support. Special attention should be given to patients with hereditary predisposition and schizoid premorbid personality. Modern treatment approaches contribute to improving the course of the disease; however, additional preventive measures are necessary.