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Early identification of non-remission in first-episode psychosis in a two-year outcome study

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Abstract:

Simonsen E, Friis S, Opjordsmoen S, Mortensen EL, Haahr U, Melle I, Joa I, Johannessen JO, Larsen TK, Røssberg JI, Rund BR, Vaglum P, McGlashan TH. Early identification of non-remission in first-episode psychosis in a two-year outcome study. Objective: 

To identify predictors of non-remission in first-episode, non-affective psychosis. Method: 

During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years. Results: 

One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for <6 months (n = 38) and for more than 6 months (n = 207), duration of untreated psychosis (DUP) was the only variable that significantly differentiated the groups (median DUP: 25.5, 14.4 and 6.0 weeks, respectively). Three months univariate predictors of non-remission were being single, longer DUP, core schizophrenia, and less excitative and more negative symptoms at baseline. Two-year predictors were younger age, being single and male, deteriorating premorbid social functioning, longer DUP and core schizophrenia. In multivariate analyses DUP, negative and excitative symptoms predicted non-remission at 3 months, but only DUP predicted at 2 years. Conclusion: 

Long DUP predicted both 3 month and 2-year non-remission rates in first-episode psychosis.

Keywords: duration of untreated psychosis; first-episode psychosis; negative symptoms; outcome; premorbid functioning

Document Type: Research Article

DOI: https://doi.org/10.1111/j.1600-0447.2010.01598.x

Affiliations: 1: Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde University and University of Copenhagen, Copenhagen, Denmark 2: Department of Psychiatry, Oslo University Hospital, Ullevål and Institute of Clinical Medicine, University of Oslo, Oslo, Norway 3: Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen 4: Early Psychosis Intervention Center and University of Copenhagen, Region Zealand Psychiatry Roskilde, Roskilde, Denmark 5: Division of Psychiatry, Regional Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger 6: Psykisk Helse, Sykehuset Asker og Bærum, Vestre Viken HF and Department of Psychology, University of Oslo, Oslo 7: Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway 8: Department of Psychiatry, Yale University, New Haven, CT, USA

Publication date: 2010-11-01

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