The Association of Antipsychotic Postponement With 5-Year Outcomes of Adolescent First-Episode Psychosis.
| Autor: | Bergström, Tomi, Gauffin, Tapio |
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| Předmět: |
DIAGNOSIS of schizophrenia
DRUG therapy for psychoses DRUG efficacy NONPARAMETRIC statistics RESEARCH ANTIDEPRESSANTS CONFIDENCE intervals CLINICAL trials PSYCHOSES MULTIPLE regression analysis MANN Whitney U Test TREATMENT delay (Medicine) PRE-tests & post-tests COMPARATIVE studies HOSPITAL care DESCRIPTIVE statistics RESEARCH funding ODDS ratio STATISTICAL correlation DATA analysis software ANXIETY disorders ANTIPSYCHOTIC agents LONGITUDINAL method EARLY medical intervention EVALUATION |
| Zdroj: | Schizophrenia Bulletin Open; Jan2023, Vol. 4 Issue 1, p1-9, 9p |
| Abstrakt: | Background and Hypothesis Based on the need-adapted approach, delaying antipsychotics could help identify first-episode psychosis (FEP) adolescents who might not require them. However, some individuals might need antipsychotics, and postponing could harm their prognosis. This nationwide register-based follow-up aimed to test these two hypotheses. Study Design All adolescents aged 13–20 with a psychotic disorder (ICD-10 codes: F20–F29) in Finland between 2003 and 2013 were identified (n = 6354) from national registers. For each case, a fixed 1825-day follow-up period was established from the onset of psychosis or until death. The outcome was considered "good" if adolescents did not die and had not received psychiatric treatment and/or disability allowances during the final year of follow-up. Testing the first hypothesis involved all antipsychotic treatment-naïve adolescents with FEP (n = 3714). The second hypothesis was tested with a sub-sample of only those who had received antipsychotics during follow-up (n = 3258). To account for baseline confounders, hypotheses were tested via a stabilized inverse probability of treatment weighted generalized linear models with logit link function. Study Results Immediate antipsychotic treatment after the onset of psychosis was associated with poor 5-year outcome (adjusted odds ratio [aOR]: 1.8, 95% CI: 1.6–2.1). There was no statistically significant association between antipsychotic postponement and treatment outcome in those who eventually received antipsychotic treatment (aOR: 1.02, 95% CI: 0.7–1.2, P :.8), thus not providing support for second hypothesis. Conclusions There is a significant subgroup of adolescent with psychosis who do not require immediate antipsychotic treatment. A more robust design is needed to evaluate the causality of the observed association. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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