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Long-term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes.

Abstract：

OBJECTIVE:To evaluate morbidity during long-term follow-up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major psychotic episodes. METHODS:We followed adult subjects systematically at regular intervals from hospitalization for first-lifetime episodes of major affective and schizoaffective disorders with initial psychotic features. We compiled % of days with morbidity types from detailed records and life charts, reviewed earliest antecedent morbidities, compared both with final diagnoses and initial presenting illness types, and evaluated morbidity risk factors with regression modeling. FINDINGS:With final diagnoses of bipolar-I (BD-I, n = 216), schizoaffective (SzAffD, 71), and major depressive (MDD, 42) disorders, 329 subjects were followed for 4.47 [CI: 4.20-4.47] years. Initial episodes were mania (41.6%), mixed states (24.3%), depression (19.5%), or apparent nonaffective psychosis (14.6%). Antecedent morbidity presented 12.7 years before first episodes (ages: SzAffD ≤ BD-I < MDD). Long-term % of days ill ranked SzAffD (83.0%), MDD (57.8%), BD-I (45.0%). Morbidity differed by diagnosis and first-episode types, and was predicted by first episodes and suggested by antecedent illnesses. Long-term wellness was greater with BD-I diagnosis, first episode not mixed or psychotic nonaffective, rapid onset, and being older at first antecedents, but not follow-up duration. CONCLUSIONS:Initially, psychotic BD-I, SzAffD, or MDD subjects followed for 4.47 years from first hospitalization experienced much illness, especially depressive or dysthymic, despite ongoing clinical treatment. Antecedent symptoms arose years before index first episodes; antecedents and first episode types predicted types and amounts of long-term morbidity, which ranked: SzAffD > MDD > BD-I.

journal_name

Acta Psychiatr Scand

journal_title

Acta psychiatrica Scandinavica

authors

Salvatore P,Khalsa HK,Tohen M,Baldessarini RJ

doi

10.1111/acps.13243

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

50-60

issue

eissn

0001-690X

issn

1600-0447

journal_volume

143

pub_type

杂志文章

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Long-term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes.