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Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial.

https://arctichealth.org/en/permalink/ahliterature91568
Source
Can J Psychiatry. 2008 Oct;53(10):660-70
Publication Type
Article
Date
Oct-2008
Author
Petersen Lone
Thorup Anne
Øqhlenschlaeger Johan
Christensen Torben Øqstergaard
Jeppesen Pia
Krarup Gertrud
Jørrgensen Per
Mortensen Erik Lykke
Nordentoft Merete
Author Affiliation
Bispebjerg Hospital, Department of Psychiatry, Copenhagen NV, Denmark. lonepetersen@mail.dk
Source
Can J Psychiatry. 2008 Oct;53(10):660-70
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Combined Modality Therapy
Community Mental Health Services
Comorbidity
Denmark
Female
Follow-Up Studies
Humans
Male
Patient Compliance - psychology
Psychotherapy - methods
Psychotropic Drugs - therapeutic use
Schizophrenia - epidemiology - rehabilitation
Schizophrenic Psychology
Substance-Related Disorders - epidemiology - psychology - rehabilitation
Young Adult
Abstract
OBJECTIVE: To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD). METHOD: We conducted a 2-year follow-up of a cohort of patients (n = 547) with first-episode SSD. We evaluated the patients on demographic variables, diagnosis, duration of untreated psychosis (DUP), premorbid functioning, psychotic and negative symptoms, substance abuse, adherence to medication, and service use. ORs were calculated with logistic regression analyses. RESULTS: A total of 369 patients (67%) participated in the follow-up interview. After 2 years, 36% remitted and 17% were considered fully recovered. Full recovery was associated with shorter DUP, better premorbid adjustment, fewer negative symptoms at baseline, no substance abuse at baseline, and adherence to medication and OPUS treatment. CONCLUSIONS: Several predictive factors were identified, and focus should be on potentially malleable predictors of outcome, for example, reducing DUP and paying special attention to patients who are unlikely to achieve good outcome, for example, patients with a substance abuse problem and poor premorbid adjustment.
PubMed ID
18940034 View in PubMed
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Frequency and predictive values of first rank symptoms at baseline among 362 young adult patients with first-episode schizophrenia Results from the Danish OPUS study.

https://arctichealth.org/en/permalink/ahliterature94073
Source
Schizophr Res. 2007 Dec;97(1-3):60-7
Publication Type
Article
Date
Dec-2007
Author
Thorup Anne
Petersen Lone
Jeppesen Pia
Nordentoft Merete
Author Affiliation
Bispebjerg Hospital, Psychiatric Department, Denmark. atv@dadlnet.dk
Source
Schizophr Res. 2007 Dec;97(1-3):60-7
Date
Dec-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - administration & dosage
Cohort Studies
Combined Modality Therapy
Comorbidity
Cross-Sectional Studies
Delusions - diagnosis - epidemiology
Denmark
Female
Follow-Up Studies
Hallucinations - diagnosis - epidemiology
Humans
Male
Patient care team
Psychiatric Status Rating Scales
Psychotherapy
Schizophrenia - diagnosis - epidemiology - rehabilitation
Schizophrenic Psychology
Substance-Related Disorders - diagnosis - epidemiology - rehabilitation
Abstract
AIM: To investigate the frequency of the Schneiderian First Rank Symptoms (FRSs) in a representative group of patients with first-episode schizophrenia and to analyse the predictive value of these symptoms in relation to psychopathology, work situation, depression, dependency and admission after 2 years of treatment. METHOD: 547 patients were included in the Danish OPUS trial. A subgroup of these, namely the 388 patients who fulfilled the diagnostic criteria for schizophrenia (ICD-10), was included in this study. Data from SCAN interviews were used to describe the frequency of the different first rank symptoms and to compare the characteristics of the patients with and without FRSs. RESULTS: FRSs were very common among these patients with first-episode schizophrenia. Only 16% reported no FRSs at all. Almost half of the patients had experienced commenting or discussing voices, and more than 40% had experienced loud thoughts. More patients with than without FRSs had some kind of substance abuse. FRSs at baseline did not predict the level of scores in the psychotic, negative or disorganized dimension after 2 years. Having FRSs at baseline was related to a significantly lower number of days of admission during the two-year period, but was not associated with antipsychotic medication or depression after 2 years. CONCLUSION: FRSs are very common among first-episode psychosis patients, but their predictive value seems to be limited with respect to outcome measures like psychopathology, work or substance abuse. However, FRSs did predict a lower mean of days of admission.
PubMed ID
17698323 View in PubMed
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Transition rates from schizotypal disorder to psychotic disorder for first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment.

https://arctichealth.org/en/permalink/ahliterature82712
Source
Schizophr Res. 2006 Mar;83(1):29-40
Publication Type
Article
Date
Mar-2006
Author
Nordentoft Merete
Thorup Anne
Petersen Lone
Ohlenschlaeger Johan
Melau Marianne
Christensen Torben Østergaard
Krarup Gertrud
Jørgensen Per
Jeppesen Pia
Author Affiliation
Bispebjerg Hospital, Department Psychiatry, Bispebjerg, Bakke 23, DK-2400 Copenhagen NV, Denmark. merete.nordentoft@dadlnet.dk
Source
Schizophr Res. 2006 Mar;83(1):29-40
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Combined Modality Therapy
Community Mental Health Services - organization & administration
Continuity of Patient Care
Delivery of Health Care, Integrated
Denmark
Disease Progression
Female
Humans
Male
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Psychotherapy - methods
Psychotic Disorders - prevention & control
Schizophrenia - prevention & control
Schizotypal Personality Disorder - physiopathology - therapy
Abstract
BACKGROUND: Only a few randomized clinical trials have tested the effect on transition rates of intervention programs for patients with sub-threshold psychosis-like symptoms. AIM: To examine whether integrated treatment reduced transition to psychosis for first-contact patients diagnosed with schizotypal disorder. METHODS: Seventy-nine patients were randomized to integrated treatment or standard treatment. Survival analysis with multivariate Cox-regression was used to identify factors determinant for transition to psychotic disorder. RESULTS: In the multivariate model, male gender increased risk for transition to psychotic disorder (relative risk=4.47, (confidence interval 1.30-15.33)), while integrated treatment reduced the risk (relative risk=0.36 (confidence interval 0.16-0.85)). At two-year follow-up, the proportion diagnosed with a psychotic disorder was 25.0% for patients randomized to integrated treatment compared to 48.3% for patients randomized to standard treatment. CONCLUSION: Integrated treatment postponed or inhibited onset of psychosis in significantly more cases than standard treatment.
PubMed ID
16504481 View in PubMed
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Intensive treatment models and coercion.

https://arctichealth.org/en/permalink/ahliterature87682
Source
Nord J Psychiatry. 2007;61(5):369-78
Publication Type
Article
Date
2007
Author
Ohlenschlaeger Johan
Thorup Anne
Petersen Lone
Jeppesen Pia
Køster Anne
Munkner Runa
Nordentoft Merete
Author Affiliation
Sct. Hans Hospital, Roskilde, Denmark. oeh@dadlnet.dk
Source
Nord J Psychiatry. 2007;61(5):369-78
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Clinical Protocols
Coercion
Commitment of Mentally Ill - statistics & numerical data
Community Mental Health Services - methods
Denmark
Female
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Length of Stay
Long-Term Care
Male
Patient Dropouts
Patient satisfaction
Psychiatric Status Rating Scales - statistics & numerical data
Psychotherapy - methods
Psychotic Disorders - diagnosis - rehabilitation - therapy
Psychotropic Drugs - therapeutic use
Schizophrenia - diagnosis - rehabilitation - therapy
Schizophrenic Psychology
Severity of Illness Index
Treatment Outcome
Abstract
Little evidence exists concerning the optimal treatment for patients with first-episode schizophrenia-spectrum disorders and the effect on traditional outcomes. The aim was to investigate whether optimal treatment models have an effect on the level of use of coercion and on traditional outcomes. Hospital-based Rehabilitation, an intensified inpatient treatment model, Integrated Treatment, an intensified model of Assertive Community Treatment, and standard treatment were compared for patients with first-episode schizophrenia-spectrum disorders. Ninety-four patients with first-episode schizophrenia-spectrum disorders estimated to benefit from long-term hospitalization were included consecutively from the Copenhagen OPUS-trial and randomized to the three treatment models. At 1-year follow-up, Hospital-based Rehabilitation and Integrated Treatment had better scores on symptoms in the negative dimension and on client satisfaction. Integrated Treatment had fewer bed-days, more patients living in non-supervised accommodation, and better score on quality of life. No differences were found as to the use of coercion. This study adds to the evidence that intensified treatment models are superior to standard treatment. A higher number of bed-days in Hospital-based Rehabilitation did not influence the effect on the outcomes measured.
PubMed ID
17990199 View in PubMed
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