First-episode mania: a neglected priority for early intervention

Details

Serval ID
serval:BIB_D2FBF9922F25
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
First-episode mania: a neglected priority for early intervention
Journal
Australian and New Zealand Journal of Psychiatry
Author(s)
Conus Philippe, McGorry Patrick D.
ISSN
0004-8674
Publication state
Published
Issued date
2002
Peer-reviewed
Oui
Volume
36
Number
2
Pages
158-172
Language
english
Notes
SAPHIRID:62856
Abstract
OBJECTIVE: While first-episode (FE) psychosis has become an important field of research, FE affective psychoses, and mania in particular, have been relatively neglected. This paper summarizes current knowledge about FE mania and explores the potential for early intervention. METHOD: The main computerized psychiatric literature databases were accessed. RESULTS: When functional as well as symptomatic variables are considered, the outcome of mania is not as good as was formerly believed, a characteristic which is already present from the first episode. Various factors (lower socio-economic status, younger age at onset of illness, poor adherence to treatment, presence of comorbidity) have been identified as possible predictors of poor outcome. The prognostic value of the presence of psychotic symptoms and their congruence to mood, as well as the diagnostic subgroup, is less well established. This literature review also reveals striking similarities between manic and schizophreniform first episodes. Poor functional outcome in a significant proportion of patients following the first episode, high risk of suicide, high prevalence of comorbid diagnoses, worse outcome with a younger age at onset and with longer delay until treatment is initiated, and finally early presence of neuro-anatomical changes, are observed in both syndromes. CONCLUSIONS: This pattern justifies the development of early intervention strategies for FE manic patients and supports more exploratory research to identify prodromal symptoms, which might ultimately lead to even earlier focus on preventive interventions.
Pubmed
Web of science
Create date
10/03/2008 10:00
Last modification date
20/08/2019 15:53
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