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Clinical epidemiologic first-episode psychosis: 1-year outcome and predictors.

https://arctichealth.org/en/permalink/ahliterature163098
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Publication Type
Article
Date
Jul-2007
Author
E. Simonsen
S. Friis
U. Haahr
J O Johannessen
T K Larsen
I. Melle
S. Opjordsmoen
B R Rund
P. Vaglum
T. McGlashan
Author Affiliation
Roskilde Psychiatric University Hospital Fjorden, Roskilde, Denmark. rfes@ra.dk
Source
Acta Psychiatr Scand. 2007 Jul;116(1):54-61
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adult
Affect
Denmark - epidemiology
Female
Humans
Male
Norway - epidemiology
Prospective Studies
Psychotic Disorders - drug therapy - epidemiology
Remission Induction
Schizophrenia - drug therapy - epidemiology
Social Behavior
Abstract
To describe 1-year outcome in a large clinical epidemiologic sample of first-episode psychosis and its predictors.
A total of 301 patients with first-episode psychosis from four healthcare sectors in Norway and Denmark receiving common assessments and standardized treatment were evaluated at baseline, at 3 months, and at 1 year.
Substantial clinical and social improvements occurred within the first 3 months. At 1-year 66% were in remission, 11% in relapse, and 23% continuously psychotic. Female gender and better premorbid functioning were predictive of less severe negative symptoms. Shorter DUP was predictive for shorter time to remission, stable remission, less severe positive symptoms, and better social functioning. Female gender, better premorbid social functioning and more education also contributed to a better social functioning.
This first-episode sample, being well treated, may be typical of the early course of schizophrenia in contemporary centers.
PubMed ID
17559601 View in PubMed
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Early detection of psychosis: positive effects on 5-year outcome.

https://arctichealth.org/en/permalink/ahliterature140097
Source
Psychol Med. 2011 Jul;41(7):1461-9
Publication Type
Article
Date
Jul-2011
Author
T K Larsen
I. Melle
B. Auestad
U. Haahr
I. Joa
J O Johannessen
S. Opjordsmoen
B R Rund
J I Rossberg
E. Simonsen
P. Vaglum
S. Friis
T. McGlashan
Author Affiliation
Stavanger University Hospital, Psychiatric Clinic, Stavanger, Norway. tkmaclarsen@mac.com
Source
Psychol Med. 2011 Jul;41(7):1461-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Denmark
Early Diagnosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway
Outcome Assessment (Health Care) - methods
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology - therapy
Young Adult
Abstract
During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long-term outcome. This study reports the effects of reducing DUP on 5-year course and outcome.
During 1997-2000 a total of 281 consecutive patients aged >17 years with first episode non-affective psychosis were recruited, of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) programme with public information campaigns and low-threshold psychosis detection teams was established in one healthcare area (ED-area), but not in a comparable area (no-ED area). Both areas ran equivalent treatment programmes during the first 2 years and need-adapted treatment thereafter.
At the start of treatment, ED-patients had shorter DUP and less symptoms than no-ED-patients. There were no significant differences in treatment (psychotherapy and medication) for the 5 years. Mixed-effects modelling showed better scores for the ED group on the Positive and Negative Syndrome Scale negative, depressive and cognitive factors and for global assessment of functioning for social functioning at 5-year follow-up. The ED group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders.
Early treatment had positive effects on clinical and functional status at 5-year follow-up in first episode psychosis.
Notes
Comment In: Psychol Med. 2012 Mar;42(3):669-7022099925
PubMed ID
20942996 View in PubMed
Less detail