The concept of treatment-resistant schizophrenia can be understood in two ways:

1. 1) as the persistence of schizophrenic symptoms in a patient taking a medication supposed to be efficient or

2. 2) as inefficiency of treatments available for certain forms of schizophrenia such as the early-onset form.

To study the relationship between early onset of schizophrenia and ulterior treatment resistance: does early onset of schizophrenia predict response to antipsychotics?

Through a case report and study of existing literature on the subject, we wanted to understand whether early onset of schizophrenia would predict resistance to antipsychotics.

We present the case of a male patient who developed schizophrenia (undifferentiated subtype according to DSM IV) since age 12. He progressively became disorganized, having severe alteration of reality testing, suffering from hallucinations and delusions leading to school dropout and social isolation. He received first and second generation antipsychotics at adequate dosage and during a sufficient time period without improvement of symptoms. We diagnosed treatment resistant schizophrenia according to the Kane criteria. Patient was then started on Clozapine from age 18 leading finally to remission of symptoms but social rehabilitation still needs to be done.

The authors conclude that early onset of schizophrenia potentially predicts poor treatment response. However, other factors such as symptom severity should be taken into account.