Citation

Conus P, Cotton S, Schimmelmann BG, McGorry PD, Lambert M. Soc. Psychiatry Psychiatr. Epidemiol. 2017; 52(9): 1089-1099.

Copyright

(Copyright © 2017, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-017-1388-7

PMID

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.

Language: en

Keywords

Humans; Adult; Female; Male; Adolescent; Young Adult; Psychiatric Status Rating Scales; Cohort Studies; Treatment Outcome; Schizophrenia; Employment; Functioning; Symptoms; First episode psychosis; Psychotic Disorders; Outcome; Predictors; Independent Living