Rates and predictors of 18-months remission in an epidemiological cohort of 661 patients with first-episode psychosis.

Abstract:

OBJECTIVES:Most first episode psychosis (FEP) outcome studies are based on patient samples enrolled through an informed consent procedure, which may induce important biases. Our aim was to study the 18-month outcome of FEP in an epidemiological sample of patients treated at the Early Psychosis Prevention and Intervention Centre (EPPIC). METHODS:The files of 661 FEP patients treated for up to 18 months between 1998 and 2000 were assessed. Symptomatic remission was defined as receiving a score ≤3 on the Clinical Global Impressions (CGI) scales, and functional remission as concurrent fulfillment of occupation/employment and independent living. Predictors were analyzed using stepwise logistic regression models. RESULTS:At endpoint, 63% of FEP patients had reached symptomatic remission and 44% functional remission. Duration of untreated psychosis, baseline symptom intensity, time in service and decrease or remission of substance use, predicted both symptomatic and functional outcome. A history of suicide attempt or non-adherence to medication was linked to lower likelihood to reach symptomatic remission while pre-morbid GAF and employment at baseline were linked to functional outcome. CONCLUSIONS:The development of early intervention strategies should be pursued, in order both to provide treatment before symptoms reach a high intensity and to maintain social integration. Specific strategies need to promote engagement, facilitate adherence to medication and to create a framework where key issues such as substance abuse co-morbidity can be addressed.

authors

Conus P,Cotton S,Schimmelmann BG,McGorry PD,Lambert M

doi

10.1007/s00127-017-1388-7

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

1089-1099

issue

9

eissn

0933-7954

issn

1433-9285

pii

10.1007/s00127-017-1388-7

journal_volume

52

pub_type

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