Predictors of favourable outcome in young people with a first episode psychosis without antipsychotic medication.

Détails

ID Serval
serval:BIB_9630CDB6BCD5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Predictors of favourable outcome in young people with a first episode psychosis without antipsychotic medication.
Périodique
Schizophrenia research
Auteur(s)
Conus P., Cotton S.M., Francey S.M., O'Donoghue B., Schimmelmann B.G., McGorry P.D., Lambert M.
ISSN
1573-2509 (Electronic)
ISSN-L
0920-9964
Statut éditorial
Publié
Date de publication
07/2017
Peer-reviewed
Oui
Volume
185
Pages
130-136
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Data from the literature suggests that some first episode psychosis (FEP) patients may recover without antipsychotic medication. There is however no reliable way to identify them. In a previous paper we found, in a cohort of 584 FEP patients, that those consistently refusing medication had poorer pre-morbid functioning, less insight, higher rate of substance use and poorer outcome. However, some medication refusers, had a favourable outcome. The study aim was to identify predictors of good short term outcome despite non-exposure to medication.
The Early Psychosis Prevention and Intervention Centre (EPPIC) admitted 786 FEP patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. Data on medication adherence was available in 584 patients. Among the 17.9% of patients who consistently refused medication over the entire treatment phase we compared patients who had a favourable symptomatic and functional outcome with those who did not.
Among patients who consistently refused medication, 41% achieved symptomatic remission and 33% reached functional recovery. Predictors of symptomatic remission were a better premorbid functioning level, higher education and employment status at baseline. Predictors of functional recovery were a shorter duration of the prodrome phase, less severe psychopathology at baseline and lower cannabis use.
Despite limitations mainly linked to the fact that non-exposure to antipsychotic medication was based on patient's treatment refusal, this study identified some characteristics which may contribute to the identification of a sub-group of FEP patients who may have good short term outcome without antipsychotic treatment.

Mots-clé
Adolescent, Adult, Antipsychotic Agents/therapeutic use, Cohort Studies, Female, Humans, Male, Patient Compliance, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychotic Disorders/drug therapy, Psychotic Disorders/psychology, Treatment Outcome, Young Adult, Antipsychotic medication, Psychosis, Recovery, Schizophrenia
Pubmed
Web of science
Création de la notice
16/01/2017 10:15
Dernière modification de la notice
20/08/2019 15:58
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