Clinical and treatment predictors of relapse during a three-year follow-up of a cohort of first episodes of schizophrenia.

Autor: Bioque M; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Medicine, University of Barcelona, Barcelona, Spain. Electronic address: mbioque@clinic.cat., Mezquida G; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain., Amoretti S; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Medicine, University of Barcelona, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain., García-Rizo C; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Medicine, University of Barcelona, Barcelona, Spain., López-Ilundain JM; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain; Navarra Health Research Institute (IdiSNA), Pamplona, Navarra, Spain., Diaz-Caneja CM; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain., Zorrilla I; Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Bioaraba, Spain., Mané A; Hospital del Mar Medical Research Institute (IMIM), Spain; Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain., Rodriguez-Jimenez R; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain., Corripio I; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau, (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Spain., Pomarol-Clotet E; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain., Ibáñez Á; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain., Usall J; Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain., Contreras F; Psychiatric Unit, Bellvitge Universitary Hospital, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; IDIBELL, L'Hospitalet de Llobregat, Spain., Mas S; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain; Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain., Vázquez-Bourgon J; Department of Psychiatry, University Hospital Marqués de Valdecilla, Spain; Instituto de Investigación sanitaria Valdecilla (IDIVAL), Spain; University of Cantabria, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain., Cuesta MJ; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain; Navarra Health Research Institute (IdiSNA), Pamplona, Navarra, Spain., Parellada M; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain., González-Pinto A; Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Bioaraba, Spain., Hidalgo-Figueroa M; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Cádiz, Spain., Bernardo M; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Medicine, University of Barcelona, Barcelona, Spain. Electronic address: bernardo@clinic.cat.
Jazyk: angličtina
Zdroj: Schizophrenia research [Schizophr Res] 2022 May; Vol. 243, pp. 32-42. Date of Electronic Publication: 2022 Feb 26.
DOI: 10.1016/j.schres.2022.02.026
Abstrakt: Relapses are frequent in the first years following a first episode of schizophrenia (FES), being associated with a higher risk of developing a chronic psychotic disorder, and poor clinical and functional outcomes. The identification and intervention over factors associated with relapses in these early phases are timely and relevant. In this study, 119 patients in remission after a FES were closely followed over three years. Participants came from the 2EPS Project, a coordinated, naturalistic, longitudinal study of 15 tertiary centers in Spain. Sociodemographic, clinical, treatment and substance abuse data were analyzed. 49.6% of the participants relapsed during the 3-years follow-up. None of the baseline demographic and clinical characteristics analyzed showed a statistically significant association with relapses. 22% of patients that finished the follow-up without relapsing were not taking any antipsychotic. The group that relapsed presented higher mean antipsychotics doses (381.93 vs. 242.29 mg of chlorpromazine equivalent/day, p = 0.028) and higher rates of antipsychotic polytherapy (28.6% vs. 13%, p < 0.001), benzodiazepines use (30.8% vs. 8.5%, p < 0.001), side effects reports (39.2% vs. 25%, p = 0.022), psychological treatment (51.8% vs. 33.9%, p = 0.03), and cannabis consumption (93.2% vs. 56.7%, p < 0.001). Clozapine use was notably higher in the group that reminded in remission (21.7% vs. 8.2%, p < 0.019). These findings may guide clinicians to detect subgroups of patients with higher risk to present a second episode of psychosis, focusing on measures to ensure an adequate treatment or facilitating cannabis use cessation. This study supports future research to identify relapse prevention strategies for patients in early phases of schizophrenia.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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