Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study

Altamura, Alfredo Carlo; Bassetti, Roberta; Sassella, F.; Salvadori, Daniele; Mundo, Emanuela

doi:10.1016/s0920-9964(00)00187-0

Cited by 85 publications

(56 citation statements)

References 53 publications

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“…The largest portion of the patients was from the European part of the W‐SOHO study, in which there was no relationship between age at onset and relapsing (Haro et al, 2006). Three studies reported a significant relationship between age at onset and relapsing: Ascher‐Svanum et al (2010) found that those with relapse during the 1‐year follow‐up period were over 2 years younger at onset than those not having relapse and (Altamura et al’s (2001) results showed a 2.9‐year difference. Eaton's results in India, however, showed that age at onset above 25 increased the risk of relapsing (Eaton, Thara, Federman, & Tien, 1998).…”

Section: Resultsmentioning

confidence: 99%

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Immonen

Jääskeläinen

Korpela

et al. 2017

Early Intervention Psych

215

116

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The aim of this study was to analyse the effect of age at onset on the long‐term clinical, social and global outcomes of schizophrenia through a systematic review and a meta‐analysis. Original studies were searched from Web of Science, PsycINFO, Pubmed and Scopus, as well as manually. Naturalistic studies with at least a 2‐year follow‐up were included. Of the 3509 search results, 81 articles fulfilled the inclusion criteria. The meta‐analysis was performed in Stata as a random‐effect analysis with correlation coefficients between age at onset and the outcomes (categorized into remission, relapse, hospitalization, positive symptoms, negative symptoms, total symptoms, general clinical outcome, employment, social/occupational functioning and global outcome). There was a statistically significant (P < .05) correlation between younger age at onset and more hospitalizations (number of studies, n = 9; correlation, r = 0.17; 95% confidence interval, CI 0.09–0.25), more negative symptoms (n = 7; r = 0.14; 95% CI 0.01–0.27), more relapses (n = 3; r = 0.11; 95% CI 0.02–0.20), poorer social/occupational functioning (n = 12; r = 0.15; 95% CI 0.05–0.25) and poorer global outcome (n = 13; r = 0.14; 95% CI 0.07–0.22). Other relationships were not significant. This was the first systematic review of the effects of age at onset on the long‐term outcomes of schizophrenia. The results show that age at onset has a small, but significant impact on some of the outcomes of schizophrenia.

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Section: Resultsmentioning

confidence: 99%

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Immonen

Jääskeläinen

Korpela

et al. 2017

Early Intervention Psych

215

116

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“…8 A combinatorial analysis of duration of illness, baseline score, family history and paranoid-type predicted response to neuroleptics. 32 However, in all cases only small to moderate effects were observed which have no bearing in clinical applications. Nevertheless, their importance should not be ignored and clinical and environmental factors, together with genetic determinants of response, should be considered when selecting treatments (see published articles in this area in a latter section).…”

Section: Clinical and Environmental Factorsmentioning

confidence: 90%

“…30 Male gender, fewer previous hospitalizations and higher therapeutic doses predict better treatment response to risperidone in combination with other genetic factors. 31 Two independent studies associated duration of treatment (DUP) with antipsychotic response whereby longer DUP predicted lower response to antipsychotics in first-episode schizophrenia, 32 and shorter duration of untreated psychosis (DUP) and good premorbid function were both independently associated with better response to olanzapine or haloperidol. 8 A combinatorial analysis of duration of illness, baseline score, family history and paranoid-type predicted response to neuroleptics.…”

Section: Clinical and Environmental Factorsmentioning

confidence: 99%

Pharmacogenetics and pharmacogenomics of schizophrenia: a review of last decade of research

2007

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The last decade of research into the pharmacogenetics of antipsychotics has seen the development of genetic tests to determine the patients' metabolic status and the first attempts at personalization of antipsychotic treatment. The most significant results are the association between drug metabolic polymorphisms, mainly in cytochrome P450 genes, with variations in drug metabolic rates and side effects. Patients with genetically determined CYP2D6 poor metabolizer (PMs) status may require lower doses of antipsychotic. Alternatively, CYP2D6 ultrarapid matabolizers (UMs) will need increased drug dosage to obtain therapeutic response. Additionally, polymorphisms in dopamine and serotonin receptor genes are repeatedly found associated with response phenotypes, probably reflecting the strong affinities that most antipsychotics display for these receptors. In particular, there is important evidence suggesting association between dopamine 2 receptor (D2) polymorphisms (Taq I and À141-C Ins/Del) and a dopamine 3 receptor (D3) polymorphism (Ser9Gly) with antipsychotic response and drug-induced tardive dyskinesia. Additionally, there is accumulating evidence indicating the influence of a 5-HT2C polymorphism (À759ÀT/C) in antipsychotic-induced weight gain. Application of this knowledge to clinical practice is slowly gathering pace, with pretreatment determination of individual's drug metabolic rates, via CYP genotyping, leading the field. Genetic determination of patients' metabolic status is expected to bring clinical benefits by helping to adjust therapeutic doses and reduce adverse reactions. Genetic tests for the pretreatment prediction of antipsychotic response, although still in its infancy, have obvious implications for the selection and improvement of antipsychotic treatment. These developments can be considered as successes, but the objectives of bringing pharmacogenetic and pharmacogenomic research in psychiatric clinical practice are far from being realized. Further development of genetic tests is required before the concept of tailored treatment can be applied to psychopharmatherapy. This review aims to summarize the key findings from the last decade of research in the field. Current knowledge on genetic prediction of drug metabolic status, general response and drug-induced side effects will be reviewed and future pharmacogenomic and epigenetic research will be discussed.

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“…Although usually not very intense, the persistence of residual symptoms might disrupt the patient's functioning and causing him distress and diminishing his quality of life [47,48]. A relapse (a later psychotic episode) is defined as ''the incidence of any major modification belonging to the psychological clinical picture, which causes the patient to be referred to a psychiatric center, to increase the dosage of the antipsychotic medication, or to be admitted to hospital'' [49]. A relapse could have occurred as a change from (1) a state of complete reestablishment (absence of psychotic symptoms) to the reappearance of psychotic symptoms, or (2) a state of partial reestablishment (stable state of persistent symptoms) up to a clear worsening of the psychotic symptoms [45,49].…”

Section: Relatives Of Patients With Psychosis Are Likelymentioning

confidence: 99%

“…A relapse (a later psychotic episode) is defined as ''the incidence of any major modification belonging to the psychological clinical picture, which causes the patient to be referred to a psychiatric center, to increase the dosage of the antipsychotic medication, or to be admitted to hospital'' [49]. A relapse could have occurred as a change from (1) a state of complete reestablishment (absence of psychotic symptoms) to the reappearance of psychotic symptoms, or (2) a state of partial reestablishment (stable state of persistent symptoms) up to a clear worsening of the psychotic symptoms [45,49]. A relapsing course can be considered a negative outcome given that not only might lead to functional deterioration and diminished stability in employment and relationships [50] but also give the individual a sense of frustration and hopelessness when facing illness.…”

Section: Relatives Of Patients With Psychosis Are Likelymentioning

confidence: 99%

Differences by Retrospective Illness Course on Burden,Expressed Emotion, Psychological Distress and Quality of Life in Relatives of Mexican Outpatients with Psychosis: A Cross-Sectional Study

GÃÂÃÂ3mez-de-Regil¹

2017

Neuropsychiatry

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Patients' illness might also affect their relatives' psychological state. The present crosssectional study aimed at assessing the levels of burden, expressed emotion, psychological distress and quality of life in a sample of relatives of Mexican outpatients with psychosis and the possible effect of illness course assessed retrospectively. Sample included 65 participants: 73.8% female; mean age of 48.7 years. Relatives self-responded the following scales: the Caregiver Burden Interview, the Family Questionnaire, the WHOQOL-BREF and the GHQ-28. Mean scores were compared by groups according to the retrospective illness course of patients (diagnosis, residual symptoms, relapses) with one tailed Mann-Whitney tests. Levels of burden, expressed emotion, psychological distress, and poor quality of life were low, significantly related and particularly influenced by patient residual symptoms. It is important to involve relatives not only as care providers but also as individuals whose psychological well-being is at risk, particularly when their ill relative present residual symptoms.

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Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study

Cited by 85 publications

References 53 publications

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Age at onset and the outcomes of schizophrenia: A systematic review and meta‐analysis

Pharmacogenetics and pharmacogenomics of schizophrenia: a review of last decade of research

Differences by Retrospective Illness Course on Burden,Expressed Emotion, Psychological Distress and Quality of Life in Relatives of Mexican Outpatients with Psychosis: A Cross-Sectional Study

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