Recurrent First-Episode Schizophrenia-Spectrum Disorder with Messianic Delusions in an Adolescent Male: Seven-Year Longitudinal Follow-Up and Long-Acting Injectable Aripiprazole Stabilization
Ivan Lopez-Ibor, MD (1,2,3,4) 1 Clínica López-ibor, Madrid, Spain. 2 Sanatorio del Dr Esquerdo, Madrid, Spain. 3 Clínica del Dr León, Madrid, Spain. South Florida Integrative Medicine, Miami, Florida. Department of Psychiatry, Madrid, Spain Corresponding author: drivanlopezibor@gmail.com Abstract Background: First-episode psychosis (FEP) in adolescence is associated with high relapse rates, increased suicide risk, and long-term functional impairment. Antipsychotic discontinuation remains one of the strongest predictors of recurrence. Long-acting injectable (LAI) antipsychotics may reduce relapse by improving treatment adherence. Case Presentation: A 17-year-old male presented with acute schizophrenia-spectrum psychosis characterized by grandiose messianic delusions, auditory hallucinations, formal thought disorder, and suicidal ideation expressed in religious terms. Organic and toxic etiologies were systematically excluded. Initial treatment with olanzapine 15 mg/day resul...