Predicting 1-year risk for relapse in patients who have discontinued or continued quetiapine after remission from first-episode psychosis
| Autor: | Eric Y.H. Chen, Sherry Kit Wa Chan, Se-Fong Hung, Gloria H.Y. Wong, Steve Tso, Christy L.M. Hui, Dicky W.S. Chung, K.T. Chan, Edwin P F Pang, C.W. Law, William G. Honer, Y C Wong, Flora Y M Mo, Jennifer Y.M. Tang, Cindy P.Y. Chiu, May M.L. Lam, Kathy P. M. Chan, Wing Chung Chang, Edwin Ho Ming Lee |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Psychosis Dibenzothiazepines Adolescent Relapse prevention Drug Administration Schedule law.invention Quetiapine Fumarate Young Adult Randomized controlled trial Double-Blind Method law Predictive Value of Tests medicine Secondary Prevention Humans Psychiatry Biological Psychiatry Aged Psychiatric Status Rating Scales Middle Aged medicine.disease Discontinuation Psychiatry and Mental health Treatment Outcome Psychotic Disorders Disinhibition Quetiapine Female medicine.symptom Psychology Neurocognitive medicine.drug Diagnosis of schizophrenia Antipsychotic Agents Follow-Up Studies |
| Zdroj: | Schizophrenia research. 150(1) |
| ISSN: | 1573-2509 |
| Popis: | Objective Relapse is common among patients with psychotic disorders. Identification of relapse predictors is important for decision regarding maintenance medication. Naturalistic studies often identify medication non-adherence as a dominant predictor. There are relatively few studies for predictors where adherence is already known. It is this situation i.e., discontinuation of medication that predictors will be most useful. We identify predictors for relapse in situations of (i) discontinuation and (ii) continuation of maintenance medication. Method Analysis of relapse predictors is based on a randomized controlled study ( n = 178) comparing relapse rates between patients who discontinued or continued medication for at least 1 year following first-episode psychosis. Demographic, clinical and neurocognitive variables were assessed at baseline as predictors of relapse within 1 year. Results Risk of relapse was 79% in the discontinuation group and 41% in the maintenance group. Predictors in the discontinuation group were diagnosis of schizophrenia, poorer semantic fluency performance, and higher blink rate. Predictors in the continuation group were disinhibition soft signs and more general psychopathology symptoms. Conclusion Different predictors of relapse were identified for first episode psychosis patients who discontinued and continued maintenance medication. Neurocognitive dysfunctions are important predictors for both groups. While signs of frontal dysfunction and dopamine hyperactivity predict relapse in the discontinuation group, sign of cognitive disinhibition predicts relapse in the continuation group. |
| Databáze: | OpenAIRE |
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