Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients.

Autor: de Beer F; Department of Biomedical Sciences, University of Groningen, University Medical Centre Groningen, Antonius Deusinglaan 1, 9713 AW, Groningen, The Netherlands. f.de.beer@umcg.nl., Koops S; Department of Biomedical Sciences, University of Groningen, University Medical Centre Groningen, Antonius Deusinglaan 1, 9713 AW, Groningen, The Netherlands., Schoevers RA; Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands., Veling W; Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands., van Beveren N; Parnassia Group for Mental Health Care, The Hague, The Netherlands.; Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands.; Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands., de Haan L; Department of Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.; Arkin, Institute for Mental Health, Amsterdam, The Netherlands., Boonstra N; Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.; NHL Stenden, University of Applied Sciences, Leeuwarden, The Netherlands.; KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands., Kikkert M; Arkin, Institute for Mental Health, Amsterdam, The Netherlands., Begemann MJH; Department of Biomedical Sciences, University of Groningen, University Medical Centre Groningen, Antonius Deusinglaan 1, 9713 AW, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Oct 02; Vol. 14 (1), pp. 22871. Date of Electronic Publication: 2024 Oct 02.
DOI: 10.1038/s41598-024-72678-4
Abstrakt: Clinical outcomes after a first-episode of psychosis (FEP) are heterogeneous. Many patient-related factors such as gender and comorbidity have been studied to predict symptomatic outcomes. However, psychiatrist-related factors such as prescription behaviour and gender have received little attention. We assessed the relationship between patients' psychiatrists, psychosis severity and daily functioning in 201 patients remitted from an FEP for a duration of one year, treated by 18 different psychiatrists. We controlled for baseline severity, dose and type of antipsychotic medication, frequency of visits, and patients' education. Symptom severity, daily functioning, and antipsychotic drug use were assessed at baseline and at 3, 6, and, 12 months follow-up. We found that psychiatrists accounted for 9.1% of the explained variance in patients' symptom severity and 10.1% of the explained variance in daily functioning.These effects persisted even when controlling for factors such as baseline severity and the prescribed dose. The effect of prescribed dose on symptom severity and daily functioning differed between psychiatrists. Treatment centre, session frequency, and medication nonadherence were not related to symptom severity. Our results emphasize the importance of individual psychiatrist factors in symptomatic outcomes after an FEP. Further identification of psychiatrist-related factors such as the quality of therapeutic alliances and shared decision-making, may optimize psychiatrists' training with the goal of improving patient outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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