Predicting first-episode psychosis patients who will never relapse over 10 years.
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Authors
Honer, William G
Lee, Edwin Hm
Chang, WC
Chan, Sherry Kw
Chen, Emily Sm
Pang, Edwin Pf
Lui, Simon Sy
Chung, Dicky Ws
Yeung, WS
Ng, Roger Mk
Lo, William Tl
Jones, Peter B
Sham, Pak
Chen, Eric Yh
Publication Date
2019-10Journal Title
Psychol Med
ISSN
0033-2917
Publisher
Cambridge University Press (CUP)
Volume
49
Issue
13
Pages
2206-2214
Language
eng
Type
Article
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Hui, C. L., Honer, W. G., Lee, E. H., Chang, W., Chan, S. K., Chen, E. S., Pang, E. P., et al. (2019). Predicting first-episode psychosis patients who will never relapse over 10 years.. Psychol Med, 49 (13), 2206-2214. https://doi.org/10.1017/S0033291718003070
Abstract
BACKGROUND: Although relapse in psychosis is common, a small proportion of patients will not relapse in the long term. We examined the proportion and predictors of patients who never relapsed in the 10 years following complete resolution of positive symptoms from their first psychotic episode. METHOD: Patients who previously enrolled in a 12-month randomized controlled trial on medication discontinuation and relapse following first-episode psychosis (FEP) were followed up after 10 years. Relapse of positive symptoms was operationalized as a change from a Clinical Global Impression scale positive score of <3 for at least 3 consecutive months to a score of ⩾3 (mild or more severe). Baseline predictors included basic demographics, premorbid functioning, symptoms, functioning, and neurocognitive functioning. RESULTS: Out of 178 first-episode patients, 37 (21%) never relapsed during the 10-year period. Univariate predictors (p ⩽ 0.1) of patients who never relapsed included a duration of untreated psychosis (DUP) ⩽30 days, diagnosed with non-schizophrenia spectrum disorders, having less severe negative symptoms, and performing better in logical memory immediate recall and verbal fluency tests. A multivariate logistic regression analysis further suggested that the absence of any relapsing episodes was significantly related to better short-term verbal memory, shorter DUP, and non-schizophrenia spectrum disorders. CONCLUSIONS: Treatment delay and neurocognitive function are potentially modifiable predictors of good long-term prognosis in FEP. These predictors are informative as they can be incorporated into an optimum risk prediction model in the future, which would help with clinical decision making regarding maintenance treatment in FEP.
Keywords
Humans, Recurrence, Logistic Models, Risk Factors, Follow-Up Studies, Memory, Psychotic Disorders, Psychiatric Status Rating Scales, Schizophrenic Psychology, Adult, Hong Kong, Female, Male, Randomized Controlled Trials as Topic, Young Adult
Identifiers
External DOI: https://doi.org/10.1017/S0033291718003070
This record's URL: https://www.repository.cam.ac.uk/handle/1810/286304
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