Effect of discontinuation v. maintenance of antipsychotic medication on relapse rates in patients with remitted/stable first-episode psychosis: a meta-analysis.

Abstract:

BACKGROUND:Discontinuation of antipsychotics predisposes patients with remitted/stable first-episode psychosis (FEP) to a higher risk of relapse, but it remains unclear how long discontinuation increases the relapse rate in these patients compared with maintenance. METHODS:This meta-analysis of randomized controlled trials (RCTs) compared relapse rates in FEP patients between antipsychotic treatment discontinuation and maintenance groups at 1, 2, 3, 6, 9, 12 (primary), and 18-24 months. The risk ratio (RR) and numbers needed to treat/harm (NNT/NNH) were calculated using a random-effects model. RESULTS:Ten RCTs were identified (n = 776; mean study duration, 18.6 ± 6.0 months). The antipsychotics were discontinued abruptly in four RCTs (which reported data only at 12 months) and after tapering off gradually over several months (mean length, 3 months) in six RCTs. Compared with the discontinuation group, the maintenance group experienced significantly fewer relapses at all time points except 1 month [RR (NNT): 2 months, 0.49 (13); 3 months, 0.46 (9); 6 months, 0.55 (6); 9 months, 0.48 (3); 12 months, 0.47 (3); and 18-24 months, 0.57 (4)]. The maintenance group was associated with higher discontinuation due to adverse events (RR, 2.61; NNH, not significant). CONCLUSIONS:Maintaining antipsychotic treatment prevented relapse for up to 24 months in FEP patients. Discontinuation of antipsychotics for ⩾2 months significantly increased the risk of relapse. However, 45.7% of patients who discontinued antipsychotics for 12 months (39.4% after 18-24 months) did not experience a relapse.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Kishi T,Ikuta T,Matsui Y,Inada K,Matsuda Y,Mishima K,Iwata N

doi

10.1017/S0033291718001393

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

772-779

issue

5

eissn

0033-2917

issn

1469-8978

pii

S0033291718001393

journal_volume

49

pub_type

杂志文章,meta分析
  • Life events and depression in women: a structural equation model.

    abstract::A non-recursive structural equation model designed to examine the reciprocal relationship between life event reports and depressive symptoms in women is presented. The model was fitted to data from a 2-year longitudinal study of life events and depression in a sample of women with 5-year-old children. The findings sug...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s003329170001984x

    authors: Fergusson DM,Horwood LJ

    更新日期:1984-11-01 00:00:00

  • Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients.

    abstract:BACKGROUND:Although psychiatric patients with eating disorders are known to be at risk for a variety of health problems, relatively little is known about eating disorders and associated health problems in other populations. An epidemiological study was conducted to investigate health problems and impairment associated ...

    journal_title:Psychological medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1017/s0033291701004640

    authors: Johnson JG,Spitzer RL,Williams JB

    更新日期:2001-11-01 00:00:00

  • Investigating renal function during lithium treatment.

    abstract::The tests that have been used to assess glomerular and tubular function in patients receiving treatment with lithium have been reviewed. The advantages and disadvantages of these are discussed. The most useful tests are the creatinine clearance, which may be predicted from the serum creatinine using a formula or nomog...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:

    authors: Waller DG,Edwards JG

    更新日期:1985-05-01 00:00:00

  • Erythrocyte membrane cation carrier, relapse rate of manic-depressive illness and response to lithium.

    abstract::Biochemical studies of manic-depressive psychosis usually correlates biochemical findings with current affective state and hence any significant findings could be secondary to mood change. The present study attempts to correlate measures of the erythrocyte membrane cation carrier with clinical events, remote in time f...

    journal_title:Psychological medicine

    pub_type: 临床试验,杂志文章

    doi:10.1017/s0033291700013805

    authors: Naylor GJ,Dick DA,Dick EG

    更新日期:1976-05-01 00:00:00

  • Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits.

    abstract:BACKGROUND:Schizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia. METHOD:A total o...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291716001902

    authors: Chen DC,Du XD,Yin GZ,Yang KB,Nie Y,Wang N,Li YL,Xiu MH,He SC,Yang FD,Cho RY,Kosten TR,Soares JC,Zhao JP,Zhang XY

    更新日期:2016-11-01 00:00:00

  • The epidemiology of blood-injection-injury phobia.

    abstract:BACKGROUND:We report the prevalence, clinical characteristics, frequency of mental health treatment, demographic correlates, frequency of co-morbid psychiatric conditions, and general health ramifications of DSM-IV blood-injection-injury phobia in the general population. METHOD:The Diagnostic Interview Schedule (versi...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291798007144

    authors: Bienvenu OJ,Eaton WW

    更新日期:1998-09-01 00:00:00

  • Reward learning deficits in Parkinson's disease depend on depression.

    abstract:BACKGROUND:Depression is one of the most common and debilitating non-motor symptoms of Parkinson's disease (PD). The neurocognitive mechanisms underlying depression in PD are unclear and treatment is often suboptimal. METHODS:We investigated the role of striatal dopamine in reversal learning from reward and punishment...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291717000769

    authors: Timmer MHM,Sescousse G,van der Schaaf ME,Esselink RAJ,Cools R

    更新日期:2017-10-01 00:00:00

  • Impulsivity and neural correlates of response inhibition in schizophrenia.

    abstract:BACKGROUND:The clinical picture of schizophrenia is frequently worsened by manifestations of impulsivity. However, the neural correlates of impulsivity in this disorder are poorly known. Although impulsivity has been related to disturbances of the neural processes underlying response inhibition, no studies have yet exa...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291710000796

    authors: Kaladjian A,Jeanningros R,Azorin JM,Anton JL,Mazzola-Pomietto P

    更新日期:2011-02-01 00:00:00

  • Bright light, negative air ions and auditory stimuli produce rapid mood changes in a student population: a placebo-controlled study.

    abstract:BACKGROUND:Bright light and high-density negative air ion exposure are efficacious for winter and non-seasonal depression compared with a low-density negative ion placebo. Similarly, auditory stimuli improve mood in clinical populations. This study compared the short-term effects of bright light, an auditory stimulus, ...

    journal_title:Psychological medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0033291706008002

    authors: Goel N,Etwaroo GR

    更新日期:2006-09-01 00:00:00

  • Should the diagnosis of major depression be made independent of or dependent upon the psychosocial context?

    abstract:BACKGROUND:The diagnosis of certain psychiatric syndromes (e.g. panic attacks, post-traumatic stress disorder) is crucially dependent on the psychosocial context in which they arise. For other syndromes (e.g. schizophrenia), the context is generally irrelevant. Should the diagnosis of major depression (MD) be made depe...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291709990845

    authors: Kendler KS,Myers J,Halberstadt LJ

    更新日期:2010-05-01 00:00:00

  • Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies.

    abstract:BACKGROUND:Psychotic symptoms occur more frequently in the general population than psychotic disorder and index risk for psychopathology. Multiple studies have reported on the prevalence of these symptoms using self-report questionnaires or clinical interviews but there is a lack of consensus about the prevalence of ps...

    journal_title:Psychological medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1017/S0033291711002960

    authors: Kelleher I,Connor D,Clarke MC,Devlin N,Harley M,Cannon M

    更新日期:2012-09-01 00:00:00

  • Effects of early life stress on depression, cognitive performance and brain morphology.

    abstract:BACKGROUND:Childhood early life stress (ELS) increases risk of adulthood major depressive disorder (MDD) and is associated with altered brain structure and function. It is unclear whether specific ELSs affect depression risk, cognitive function and brain structure. METHOD:This cross-sectional study included 64 antidep...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291716002403

    authors: Saleh A,Potter GG,McQuoid DR,Boyd B,Turner R,MacFall JR,Taylor WD

    更新日期:2017-01-01 00:00:00

  • Bipolar depression: relationship between episode length and antidepressant treatment.

    abstract:BACKGROUND:The role of antidepressant medications in bipolar depression remains controversial, mainly due to a lack of research in this area. In this study the authors examined the episode length in bipolar depression and the relationship between antidepressant therapy and episode length. METHOD:A retrospective chart ...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291702006165

    authors: Frankle WG,Perlis RH,Deckersbach T,Grandin LD,Gray SM,Sachs GS,Nierenberg AA

    更新日期:2002-11-01 00:00:00

  • Addressing perceptual insensitivity to facial affect in violent offenders: first evidence for the efficacy of a novel implicit training approach.

    abstract:BACKGROUND:Although impaired recognition of affective facial expressions has been conclusively linked to antisocial behavior, little is known about the modifiability of this deficit. This study investigated whether and under which circumstances the proposed perceptual insensitivity can be addressed with a brief implici...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291713001517

    authors: Schönenberg M,Christian S,Gaußer AK,Mayer SV,Hautzinger M,Jusyte A

    更新日期:2014-04-01 00:00:00

  • Costing mental health services.

    abstract::In this paper four principal topics are addressed: (a) the policy and political contexts in which demands arise for cost information; (b) the nature and phasing of those demands; (c) the basic rules of empirical costs research for meeting those demands; and (d) concomitant implications for the design, execution and in...

    journal_title:Psychological medicine

    pub_type: 杂志文章,评审

    doi:10.1017/s003329170003659x

    authors: Knapp M,Beecham J

    更新日期:1990-11-01 00:00:00

  • Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis.

    abstract:BACKGROUND:Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the d...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291719002794

    authors: González-Ortega I,González-Pinto A,Alberich S,Echeburúa E,Bernardo M,Cabrera B,Amoretti S,Lobo A,Arango C,Corripio I,Vieta E,de la Serna E,Rodriguez-Jimenez R,Segarra R,López-Ilundain JM,Sánchez-Torres AM,Cuesta MJ,PEPs

    更新日期:2020-12-01 00:00:00

  • The influence of prior expectations on facial expression discrimination in schizophrenia.

    abstract:BACKGROUND:Belief inflexibility is a thinking style observed in patients with schizophrenia, in which patients tend to refute evidence that runs counter to their prior beliefs. This bias has been related to a dominance of prior expectations (prior beliefs) over incoming sensory evidence. In this study we investigated t...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291712000384

    authors: Barbalat G,Rouault M,Bazargani N,Shergill S,Blakemore SJ

    更新日期:2012-11-01 00:00:00

  • Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives.

    abstract:BACKGROUND:The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relati...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291717002902

    authors: Mucci A,Galderisi S,Green MF,Nuechterlein K,Rucci P,Gibertoni D,Rossi A,Rocca P,Bertolino A,Bucci P,Hellemann G,Spisto M,Palumbo D,Aguglia E,Amodeo G,Amore M,Bellomo A,Brugnoli R,Carpiniello B,Dell'Osso L,Di Fabio

    更新日期:2018-06-01 00:00:00

  • How abnormal is the desire for slimness? A survey of eating attitudes and behaviour among Chinese undergraduates in Hong Kong.

    abstract::Using the 40-item Eating Attitudes Test and other self-report questions, a two-stage screening survey of 1020 (F 646, M 374) Chinese bilingual university students in Hong Kong showed that although female students were 'underweight' by Western standard, the majority of them and nearly all female students above a body m...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291700028531

    authors: Lee S

    更新日期:1993-05-01 00:00:00

  • Increased rates of schizophrenia among immigrants: some methodological concerns raised by Danish findings.

    abstract:BACKGROUND:Several studies during recent years have reported an increased occurrence of schizophrenia in selected immigrant groups. However, difficulties in establishing the population denominator for immigrant rates of mental disorder, selective referral for treatment, and other problems may have influenced such resul...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291797004741

    authors: Mortensen PB,Cantor-Graae E,McNeil TF

    更新日期:1997-07-01 00:00:00

  • To what extent does symptomatic improvement result in better outcome in psychotic illness? UK700 Group.

    abstract:BACKGROUND:The effectiveness of therapeutic interventions in psychosis is increasingly reported in terms of reductions in different symptom dimensions. It remains unclear, however, to what degree such symptomatic changes are accompanied by improvement in other measures such as service use, quality of life, and needs fo...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291799001014

    authors: van Os J,Gilvarry C,Bale R,van Horn E,Tattan T,White I,Murray R

    更新日期:1999-09-01 00:00:00

  • Assessing your mood online: acceptability and use of Moodscope.

    abstract:BACKGROUND:Moodscope is an entirely service-user-developed online mood-tracking and feedback tool with built-in social support, designed to stabilize and improve mood. Many free internet tools are available with no assessment of acceptability, validity or usefulness. This study provides an exemplar for future assessmen...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291712002280

    authors: Drake G,Csipke E,Wykes T

    更新日期:2013-07-01 00:00:00

  • Decision-making cognition in mania and depression.

    abstract:BACKGROUND:Despite markedly different clinical presentations, few studies have reported differences in neuropsychological functioning between mania and depression. Recent work has suggested that differences may emerge on cognitive tasks requiring affective processing, such as decision-making. The present study sought t...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291701003804

    authors: Murphy FC,Rubinsztein JS,Michael A,Rogers RD,Robbins TW,Paykel ES,Sahakian BJ

    更新日期:2001-05-01 00:00:00

  • The role of drug and alcohol abuse in recent increases in depression in the US.

    abstract::Previous studies have reported an increase in depression among recent birth cohorts. Concurrent with the increase in rates of depression, there have been increases in rates of drug and alcohol abuse and dependence. This study sought to determine if the recent increase in rates of depression could be attributed to co-m...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291700034735

    authors: Klerman GL,Leon AC,Wickramaratne P,Warshaw MG,Mueller TI,Weissman MM,Akiskal H

    更新日期:1996-03-01 00:00:00

  • Clinical course predicts long-term outcomes in bipolar disorder.

    abstract:BACKGROUND:The long-term outcomes of bipolar disorder range from lasting remission to chronic course or frequent recurrences requiring admissions. The distinction between bipolar I and II disorders has limited utility in outcome prediction. It is unclear to what extent the clinical course of bipolar disorder predicts l...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291718001678

    authors: Uher R,Pallaskorpi S,Suominen K,Mantere O,Pavlova B,Isometsä E

    更新日期:2019-05-01 00:00:00

  • Hedonic tone is associated with left supero-lateral medial forebrain bundle microstructure.

    abstract:BACKGROUND:The medial forebrain bundle (MFB) is an important pathway of the reward system. Two branches have been described using diffusion magnetic resonance imaging (MRI)-based tractography: the infero-medial MFB (imMFB) and the supero-lateral MFB (slMFB). Previous studies point to white-matter microstructural altera...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/S0033291714001949

    authors: Bracht T,Doidge AN,Keedwell PA,Jones DK

    更新日期:2015-03-01 00:00:00

  • Transcranial magnetic stimulation for depression and other psychiatric disorders.

    abstract:INTRODUCTION:Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible alternative to electroconvulsive therapy for the treatment of selected patients with depression, bipolar affective disorder and schizophrenia. The aim of this study was to evaluate the evidence for the effectiveness of rTMS...

    journal_title:Psychological medicine

    pub_type: 杂志文章,评审

    doi:10.1017/s0033291701004378

    authors: McNamara B,Ray JL,Arthurs OJ,Boniface S

    更新日期:2001-10-01 00:00:00

  • Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial.

    abstract:BACKGROUND:Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study ...

    journal_title:Psychological medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0033291712000244

    authors: Andersson E,Enander J,Andrén P,Hedman E,Ljótsson B,Hursti T,Bergström J,Kaldo V,Lindefors N,Andersson G,Rück C

    更新日期:2012-10-01 00:00:00

  • A comparison of anorexia nervosa and affective psychosis in young females.

    abstract::In a retrospective case note study, 73 young females with anorexia nervosa were compared with 88 young females with affective psychosis. These groups of patients did not differ in terms of place of residence, birth order or social class. They differed very significantly, however, in terms of age at onset of symptoms, ...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291700013295

    authors: Eagles JM,Wilson AM,Hunter D,Callender JS

    更新日期:1990-02-01 00:00:00

  • Assortative mating for major psychiatric diagnoses in two population-based samples.

    abstract:BACKGROUND:Previous studies on assortment for psychiatric disorders have reported discrepant findings. We aimed to test whether there is a significant association for psychiatric diagnoses, including alcoholism, generalized anxiety disorder, major depressive disorder, panic disorder and phobias between husbands and wiv...

    journal_title:Psychological medicine

    pub_type: 杂志文章

    doi:10.1017/s0033291798007326

    authors: Maes HH,Neale MC,Kendler KS,Hewitt JK,Silberg JL,Foley DL,Meyer JM,Rutter M,Simonoff E,Pickles A,Eaves LJ

    更新日期:1998-11-01 00:00:00