Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome

TY - JOUR

T1 - Long-term follow-up of the TIPS early detection in psychosis study

T2 - effects on 10-year outcome

AU - Hegelstad, Wenche Ten Velden

AU - Larsen, Tor K

AU - Auestad, Bjørn

AU - Evensen, Julie

AU - Haahr, Ulrik

AU - Joa, Inge

AU - Johannesen, Jan O

AU - Langeveld, Johannes

AU - Melle, Ingrid

AU - Opjordsmoen, Stein

AU - Rossberg, Jan Ivar

AU - Rund, Bjørn Rishovd

AU - Simonsen, Erik

AU - Sundet, Kjetil

AU - Vaglum, Per

AU - Friis, Svein

AU - McGlashan, Thomas

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Objective: Early detection in first-episode psychosis confers advantages for negative, cognitive, and depressive symptoms after 1, 2, and 5 years, but longitudinal effects are unknown. The authors investigated the differences in symptoms and recovery after 10 years between regional health care sectors with and without a comprehensive program for the early detection of psychosis. Method: The authors evaluated 281 patients (early detection, N=141) 18 to 65 years old with a first episode of nonaffective psychosis between 1997 and 2001. Of these, 101 patients in the early-detection area and 73 patients in the usual-detection area were followed up at 10 years, and the authors compared their symptoms and recovery. Results: A significantly higher percentage of early-detection patients had recovered at the 10-year follow-up relative to usual-detection patients. This held true despite more severely ill patients dropping out of the study in the usual-detection area. Except for higher levels of excitative symptoms in the early-detection area, there were no symptom differences between the groups. Early-detection recovery rates were higher largely because of higher employment rates for patients in this group. Conclusions: Early detection of first-episode psychosis appears to increase the chances of milder deficits and superior functioning. The mechanisms by which this strategy improves the long-term prognosis of psychosis remain speculative. Nevertheless, our findings over 10 years may indicate that a prognostic link exists between the timing of intervention and outcome that deserves additional study.

AB - Objective: Early detection in first-episode psychosis confers advantages for negative, cognitive, and depressive symptoms after 1, 2, and 5 years, but longitudinal effects are unknown. The authors investigated the differences in symptoms and recovery after 10 years between regional health care sectors with and without a comprehensive program for the early detection of psychosis. Method: The authors evaluated 281 patients (early detection, N=141) 18 to 65 years old with a first episode of nonaffective psychosis between 1997 and 2001. Of these, 101 patients in the early-detection area and 73 patients in the usual-detection area were followed up at 10 years, and the authors compared their symptoms and recovery. Results: A significantly higher percentage of early-detection patients had recovered at the 10-year follow-up relative to usual-detection patients. This held true despite more severely ill patients dropping out of the study in the usual-detection area. Except for higher levels of excitative symptoms in the early-detection area, there were no symptom differences between the groups. Early-detection recovery rates were higher largely because of higher employment rates for patients in this group. Conclusions: Early detection of first-episode psychosis appears to increase the chances of milder deficits and superior functioning. The mechanisms by which this strategy improves the long-term prognosis of psychosis remain speculative. Nevertheless, our findings over 10 years may indicate that a prognostic link exists between the timing of intervention and outcome that deserves additional study.

KW - Adult

KW - Denmark

KW - Early Diagnosis

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Norway

KW - Outcome and Process Assessment (Health Care)

KW - Prognosis

KW - Psychotic Disorders

U2 - 10.1176/appi.ajp.2011.11030459

DO - 10.1176/appi.ajp.2011.11030459

M3 - Journal article

C2 - 22407080

SN - 1139-3475

VL - 169

SP - 374

EP - 380

JO - The American Journal of Psychiatry (Spanish Edition)

JF - The American Journal of Psychiatry (Spanish Edition)

IS - 4

ER -