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Early identification of non-remission in first-episode psychosis in a two-year outcome study.

https://arctichealth.org/en/permalink/ahliterature141450
Source
Acta Psychiatr Scand. 2010 Nov;122(5):375-83
Publication Type
Article
Date
Nov-2010
Author
Erik Simonsen
S. Friis
S. Opjordsmoen
E L Mortensen
U. Haahr
I. Melle
I. Joa
J O Johannessen
T K Larsen
J I Røssberg
B R Rund
P. Vaglum
T H McGlashan
Author Affiliation
Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde University and University of Copenhagen, Copenhagen, Denmark. es@regionsjaelland.dk
Source
Acta Psychiatr Scand. 2010 Nov;122(5):375-83
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Chi-Square Distribution
Denmark - epidemiology
Female
Humans
Logistic Models
Male
Marital status
Middle Aged
Norway - epidemiology
Psychotherapy
Psychotic Disorders - diagnosis - epidemiology - psychology - therapy
Remission Induction
Sex Factors
Social Adjustment
Statistics, nonparametric
Substance-Related Disorders - psychology
Treatment Outcome
Young Adult
Abstract
To identify predictors of non-remission in first-episode, non-affective psychosis.
During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years.
One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for
Notes
Comment In: Acta Psychiatr Scand. 2011 Jun;123(6):49421219270
PubMed ID
20722632 View in PubMed
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Early Predictors of Ten-Year Course in First-Episode Psychosis.

https://arctichealth.org/en/permalink/ahliterature279449
Source
Psychiatr Serv. 2016 Apr 01;67(4):438-43
Publication Type
Article
Date
Apr-01-2016
Author
Svein Friis
Ingrid Melle
Jan Olav Johannessen
Jan Ivar Røssberg
Helene Eidsmo Barder
Julie Horgen Evensen
Ulrik Haahr
Wenche Ten Velden Hegelstad
Inge Joa
Johannes Langeveld
Tor Ketil Larsen
Stein Opjordsmoen
Bjørn Rishovd Rund
Erik Simonsen
Per Wiggen Vaglum
Thomas H McGlashan
Source
Psychiatr Serv. 2016 Apr 01;67(4):438-43
Date
Apr-01-2016
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Disease Progression
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Outcome Assessment (Health Care) - statistics & numerical data
Prognosis
Psychotic Disorders - diagnosis - drug therapy - epidemiology
Remission Induction
Schizophrenia - diagnosis - drug therapy - epidemiology
Social Skills
Time Factors
Abstract
Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first psychotic episode.
Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores =4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses.
Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow-up: deterioration in premorbid social functioning, duration of untreated psychosis (DUP) of =26 weeks, core schizophrenia spectrum disorder, and no remission within three months.
First-episode psychosis patients should be followed carefully after the start of treatment. If symptoms do not remit within three months with adequate treatment, there is a considerable risk of a poor long-term outcome, particularly for patients with a deterioration in premorbid social functioning, a DUP of at least half a year, and a diagnosis within the core schizophrenia spectrum.
PubMed ID
26567932 View in PubMed
Less detail