Long-term clinical recovery and treatment resistance in first-episode psychosis: a 10-year follow-up study

Autor: Kristin Fjelnseth Wold, Isabel Viola Kreis, Gina Åsbø, Camilla Bärthel Flaaten, Line Widing, Magnus Johan Engen, Siv Hege Lyngstad, Erik Johnsen, Torill Ueland, Carmen Simonsen, Ingrid Melle
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Schizophrenia, Vol 10, Iss 1, Pp 1-9 (2024)
Druh dokumentu: article
ISSN: 2754-6993
48880213
DOI: 10.1038/s41537-024-00489-7
Popis: Abstract Illness trajectories in people with first-episode psychosis (FEP) vary significantly over time. Identifying early-course parameters predicting outcomes is essential, but long-term data still needs to be provided. We conducted a 10-year follow-up study of a comprehensive first-episode psychosis (FEP) cohort investigating the prevalence of clinical recovery (CR) and treatment resistance (TR) after ten years, as well as clinical, demographic, and pre-illness predictors of long-term outcomes. 102 participants with FEP DSM-IV Schizophrenia spectrum disorders were recruited within their first year of treatment. The Treatment Response and Resistance in Psychosis Working Group (TRRIP) and the Remission in Schizophrenia Working Group (RSWG) criteria were used to define TR and CR, respectively. At 10-year follow-up, 29 (29%) of the participants were classified as in CR, while 32 (31%) were classified as TR. We also identified a larger middle group (n = 41, 40%) consisting of participants in partial recovery. 7% of all participants had tried Clozapine at the 10-year follow-up. Logistic regression analyses identified insidious onset (OR = 4.16) and baseline disorganized symptoms (OR = 2.96) as significantly associated with an increased risk of developing TR. Good premorbid academic adjustment (OR = 1.60) and acute onset (OR = 3.40) were associated with an increased chance of CR. We identified three long-term outcome groups by using recent consensus definitions. We also identified the potential importance of assessing baseline disorganized symptoms and monitoring patients with insidious onset more closely. Further, the findings suggest that clinicians should pay close attention to early-course parameters and provide adequate treatment to improve long-term outcomes of FEP.
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