Design and Methodology of the Korean Early Psychosis Cohort Study

Abstract

The present study details the rationale and methodology of the Korean Early Psychosis Cohort Study (KEPS), which is a clinical cohort investigation of first episode psychosis patients from a Korean population. The KEPS is a prospective naturalistic observational cohort study that follows the participants for at least 2 years. This study includes patients between 18 and 45 years of age who fulfill the criteria for one of schizophrenia spectrum and other psychotic disorders according to the diagnostic criteria of DSM-5. Early psychosis is defined as first episode patients who received antipsychotic treatment for fewer than 4 consecutive weeks after the onset of illness or stabilized patients in the early stages of the disorder whose duration of illness was less than 2 years from the initiation of antipsychotic treatment. The primary outcome measures are treatment response, remission, recovery, and relapse. Additionally, several laboratory tests are conducted and a variety of objective and subjective psychiatric measures assessing early life trauma, lifestyle pattern, and social and cognitive functioning are administered. This long-term prospective cohort study may contribute to the development of early intervention strategies and the improvement of long-term outcomes in patients with schizophrenia.

Defining Treatment Response, Remission, Relapse, and Recovery in First-Episode Psychosis: A Survey among Korean Experts

“…NR Partial in Kim et al 96 Five items maintained for ≥1 year: all psychosis (P1, P2, P3, G5, G9) and negative (N1, N4, N6) items of PANSS ≤3 (mild); SOFAS score ≥61; appropriate social functions maintained (active meeting with an acquaintance more than once a month or conversation over the phone more than twice a month (texting or SMS are excluded); and appropriate occupational functions maintained, such as employment for at least one third of the standard period, job-seeking activities, students going to school/library on a regular basis, or homemakers taking appropriate responsibility for household chores. Considering psychopathology, dosage of medication, and the CGI scale, the guidelines suggested by our Korean experts were somewhat strict compared with other definitions.…”

“…Full in Kim et al 96 Five items maintained for ≥1 year: all psychosis (P1, P2, P3, G5, G9) and negative (N1, N4, N6) items of the PANSS ≤2 (minimal); SOFAS score ≥71; appropriate social functions maintained (active meeting with an acquaintance more than twice a month, but meeting by accident or seeing or greeting at a church are excluded); appropriate occupational functions maintained, such as employment for at least half of the standard period (regardless of type of employment), job-seeking activities, students going to school/library on a regular basis, or homemakers taking appropriate responsibility for household chores.…”

Comparison of long-term efficacy and safety of blonanserin treatment in individuals with first-episode and relapsed schizophrenia: a 3-year retrospective study

“…Psychiatric hospitalization was defined as a hospitalization due to a definite reemergence of psychotic symptoms associated with a significant disturbance in social and occupational functioning as a result of worsening symptoms, which was based on at least 25% [35,36] worsening (or a 25% increase from baseline) of the Positive and Negative Syndrome Scale (PANSS) [37] score and substantial clinical deterioration, as indicated by a score of 6 or 7 on the Clinical Global Impression-Severity (CGI-S) scale [38]. Treatment discontinuation was defined as ceasing to take medication without the clinician's assent or more than two missed visits to the outpatient department.…”

“…The CGI-S scale is a tool that measures global impression of illness severity, and it is scored on a 7point scale: 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 moderately ill; 5 markedly ill; 6 = severely ill; and 7 = among the most severely ill patients [38]. Clinical improvements were defined as a 30% [36,39] decrease in the mean PANSS total score from baseline to endpoint or an improvement in the CGI-S score of at least 2 points from baseline to endpoint.…”

Validation of the Korean version of the 16-Item Prodromal Questionnaire in a Non-Help-Seeking College Population

“…Treatment delay and a long duration of untreated psychosis are associated strongly with a poor treatment response and outcomes [ 4 , 5 ]. The reported duration of untreated psychosis in Korea is longer than those in Western countries [ 6 , 7 ]. Therefore, a strategy for the early identification of psychosis in Korean young adults and adolescents is urgently needed.…”