Rates and predictors of 18-months remission in an epidemiological cohort of 661 patients with first-episode psychosis.
Soc Psychiatry Psychiatr Epidemiol
; 52(9): 1089-1099, 2017 09.
Article
in En
| MEDLINE
| ID: mdl-28477070
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotic Disorders
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
Soc Psychiatry Psychiatr Epidemiol
Journal subject:
CIENCIAS SOCIAIS
/
EPIDEMIOLOGIA
/
PSIQUIATRIA
Year:
2017
Type:
Article
Affiliation country:
Switzerland