Early detection, early symptom progression and symptomatic remission after ten years in a first episode of psychosis study

TY - JOUR

T1 - Early detection, early symptom progression and symptomatic remission after ten years in a first episode of psychosis study

AU - Ten Velden Hegelstad, Wenche

AU - Haahr, Ulrik

AU - Larsen, Tor K

AU - Auestad, Bjørn

AU - Barder, Helene

AU - Evensen, Julie

AU - Joa, Inge

AU - Johannessen, Jan O

AU - Langeveld, Johannes

AU - Melle, Ingrid

AU - Opjordsmoen, Stein

AU - Rossberg, Jan Ivar

AU - Rund, Bjørn Rishovd

AU - Simonsen, Erik

AU - Vaglum, Per

AU - McGlashan, Thomas

AU - Friis, Svein

N1 - Copyright © 2012 Elsevier B.V. All rights reserved.

PY - 2013/2

Y1 - 2013/2

N2 - Background: Poor symptom outcome remains a challenge in psychosis: At least 50% of first-episode patients continue to have positive and/or negative symptoms after ten years. Objective: To investigate rates, early predictors and early symptom progression of long-term non-remitted psychosis in an early detection study. Methods: Symptomatic remission according to new international criteria was assessed in 174 patients at ten-year follow-up. Remitted and non-remitted patients were compared on early symptom progression, and logistic regression was applied to predict non-remission. Results: At ten years, 50% of patients were in symptomatic remission. Non-remission was predicted by positive symptoms at inclusion and during the first year of treatment. Of individual symptoms only hallucinations were significantly predictive of ten-year non-remission. Early symptom differences were not reflected by differences in treatment. Conclusions: Long-term symptomatic non-remission is associated with early positive symptoms. More assertive intervention may be needed in patients who do not respond robustly in the first year of treatment, whether or not they have been detected "early".

AB - Background: Poor symptom outcome remains a challenge in psychosis: At least 50% of first-episode patients continue to have positive and/or negative symptoms after ten years. Objective: To investigate rates, early predictors and early symptom progression of long-term non-remitted psychosis in an early detection study. Methods: Symptomatic remission according to new international criteria was assessed in 174 patients at ten-year follow-up. Remitted and non-remitted patients were compared on early symptom progression, and logistic regression was applied to predict non-remission. Results: At ten years, 50% of patients were in symptomatic remission. Non-remission was predicted by positive symptoms at inclusion and during the first year of treatment. Of individual symptoms only hallucinations were significantly predictive of ten-year non-remission. Early symptom differences were not reflected by differences in treatment. Conclusions: Long-term symptomatic non-remission is associated with early positive symptoms. More assertive intervention may be needed in patients who do not respond robustly in the first year of treatment, whether or not they have been detected "early".

KW - Adolescent

KW - Adult

KW - Aged

KW - Disease Progression

KW - Early Diagnosis

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Remission Induction

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1016/j.schres.2012.10.027

DO - 10.1016/j.schres.2012.10.027

M3 - Journal article

C2 - 23219862

SN - 0920-9964

VL - 143

SP - 337

EP - 343

JO - Schizophrenia Research

JF - Schizophrenia Research

IS - 2-3

ER -