Rates and predictors of 18-months remission in an epidemiological cohort of 661 patients with first-episode psychosis.

Détails

Ressource 1Télécharger: 28477070.pdf (467.02 [Ko])
Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_313EF876F5ED
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Rates and predictors of 18-months remission in an epidemiological cohort of 661 patients with first-episode psychosis.
Périodique
Social psychiatry and psychiatric epidemiology
Auteur(s)
Conus P., Cotton S., Schimmelmann B.G., McGorry P.D., Lambert M.
ISSN
1433-9285 (Electronic)
ISSN-L
0933-7954
Statut éditorial
Publié
Date de publication
09/2017
Peer-reviewed
Oui
Volume
52
Numéro
9
Pages
1089-1099
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
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).
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.
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.
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.

Mots-clé
Adolescent, Adult, Cohort Studies, Employment/statistics & numerical data, Female, Humans, Independent Living/statistics & numerical data, Male, Psychiatric Status Rating Scales, Psychotic Disorders/epidemiology, Psychotic Disorders/therapy, Treatment Outcome, Young Adult, First episode psychosis, Functioning, Outcome, Predictors, Schizophrenia, Symptoms
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/05/2017 10:40
Dernière modification de la notice
20/08/2019 14:16
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