Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?

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Version: author
Serval ID
serval:BIB_4341BB36CF8D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?
Journal
European psychiatry
Author(s)
Golay P., Alameda L., Mebdouhi N., Baumann P., Ferrari C., Solida A., Progin P., Elowe J., Conus P.
ISSN
1778-3585 (Electronic)
ISSN-L
0924-9338
Publication state
Published
Issued date
09/2017
Peer-reviewed
Oui
Volume
45
Pages
20-26
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
While there is suggestion that early onset of psychosis is a determinant of outcome; knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients.
Two hundred and fifty-six early psychosis patients aged 18-35 were followed-up prospectively over 36 months. Patients with onset after 26 ("later onset", LO) were compared to the rest of the sample.
LO patients (32% of the sample) had shorter DUP, were less likely to be male, had better premorbid functioning and were more likely to have been exposed to trauma. They had greater insight at presentation and less negative symptoms overall. The trajectories for positive and depressive symptoms were similar in both groups. Evolution of functional level was similar in both groups, but while LO patients recovered faster, they were significantly less likely to return to premorbid functional level.
Later psychosis onset correlates with better premorbid functioning and higher rate of trauma exposure; the latter should therefore be a treatment focus in such patients. LO patients were less likely to return to premorbid functional level, which suggests that current treatment strategies may not be efficient to help patients maintain employment. The possibility of distinct illness mechanisms according to onset age and the more central role for trauma in patients with onset after age 26 needs to be further explored.
Keywords
Adult, Age of Onset, Female, Follow-Up Studies, Humans, Male, Prognosis, Psychiatric Status Rating Scales, Psychotic Disorders/diagnosis, Severity of Illness Index, Sex Factors, Time Factors, Young Adult, Age of onset, Early intervention, Early psychosis, Trauma
Pubmed
Web of science
Open Access
Yes
Create date
08/06/2017 10:06
Last modification date
13/01/2021 21:37
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