Trends and diagnostic challenges in pediatric schizophrenia spectrum disorders in Poland (2014–2019): A nationwide register-based study in an international context

The findings indicate a shift toward earlier diagnostic labeling of schizo- phrenia spectrum disorders in Polish youth and a marked overreliance on the F20 code, suggesting diagnostic oversimplification. These patterns are likely influenced by systemic and reimbursement-related factors and by the limited developmental sensitivity of the ICD-10 classification, particularly in pediatric psychiatry. Comparable coding tendencies and age-distribution shifts have been reported in U.S., German, and Scandinavian register-based studies, indicating that the Polish findings reflect administrative and structural influences on diagnostic practice rather than true epidemiological differences. Adoption of developmentally informed classification principles, such as those embodied in DSM-5, may improve diagnostic accuracy, care planning, and resource allocation in child and adolescent psychiatry.