Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up

Simonsen, Carmen; Færden, Ann; Romm, Kristin Lie; Berg, Akiah Ottesen; Bjella, Thomas; Ueland, Torill; Andreassen, Ole A.; Melle, Ingrid

doi:10.1016/j.psychres.2017.04.050

Cited by 31 publications

(27 citation statements)

References 36 publications

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“…This adds to the above discussion regarding the close relationship between depression and self-rated social disability, suggesting that depression might be the driving force. In contrast, clinician-rated symptomatic remission at 1-year follow-up was significantly predicted by baseline positive symptoms in a previous study [15]. Therefore, we can speculate that while baseline psychotic symptoms are important for clinical recovery, depression is more important for personal recovery, although this obviously requires further research.…”

Section: Gaf-f Ccontrasting

confidence: 55%

“…In other words, 37% of the sample did not consider themselves to be disabled at a clinically significant level at 1-year follow-up. Comparatively, in a previous study based on clinician-ratings, 26% of the first episode psychosis sample was in symptomatic remission [33] at 1-year follow-up, while 14% were in early clinical recovery defined as symptomatic remission; GAF-F ≥ 60; 50% work/study; and independent living [15]. Taken together, this suggests that rate of participants not considering themselves as disabled is higher than participants considered in clinical recovery as rated by clinicians.…”

Section: Discussionmentioning

confidence: 71%

“…Global functioning measured with GAF-F has been reported to improve in first episode psychosis across the first year after treatment start and to be related to psychotic symptomatology [2,15] . Satisfaction with life in general has also been reported to improve across the first 2 and 10 years, yet to be most closely related to depression in first episode psychosis and long-term schizophrenia [6,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Self-rated disability in first treated episode of psychosis: A 1-year follow-up study

Simonsen

Færden

Ueland

et al. 2018

Comprehensive Psychiatry

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Self-rated disability in first treated episode of psychosis is high, but improves across the first year, indicating signs of early recovery. Moreover, self-rated disability is related, but distinct from clinician-rated global functioning and self-rated life satisfaction, suggesting that self-rated disability should also be assessed in order to more fully describe outcomes in first episode psychosis. The findings highlight the need for specialised treatment of depression and social disability in early psychosis.

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Section: Gaf-f Ccontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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Self-rated disability in first treated episode of psychosis: A 1-year follow-up study

Simonsen

Færden

Ueland

et al. 2018

Comprehensive Psychiatry

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“…Functional remission is often defined by specific criteria [23] such as living independently and having a job/studying and may also include a specific minimum level of functioning on a rating scale [15,[23][24][25][26]. A five year first-episode schizophrenia study found 46% to be in functional remission, when defined as working or studying !50% the past year, living independently, and meeting friends !…”

Section: Introductionmentioning

confidence: 99%

“…Full recovery can be defined as a state of both symptomatic and functional remission [23,[27][28][29][30]. Around 15% of patients with firstepisode schizophrenia [14,24] fulfill the criteria for full recovery after 5-7 years.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic stability and long-term symptomatic and functional outcomes in first-episode antipsychotic-naïve patients with schizophrenia

et al. 2019

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Objective: In a prospective cohort design, we investigated: i) diagnostic stability of initially antipsychotic-naïve schizophrenia patients, ii) symptom severity including symptomatic remission, and iii) functional remission including full recovery. Methods: We included 143 antipsychotic-naïve patients with first-episode schizophrenia or schizoaffective disorder. After 4–18 years, we clinically re-evaluated diagnosis, symptom severity and functioning for 70 patients. From the nationwide Danish registers, we extracted pragmatic outcome measures for 142 patients. We examined associations between baseline variables (age at diagnosis, sex, and premorbid intelligence) and long-term outcome status (symptomatic and functional remission). Results: At 4–18 years follow-up, 80% met the criteria for schizophrenia or schizoaffective disorder, however, despite the high diagnostic stability 53% met the criteria of symptomatic and/or functional remission. Symptomatic remission characterized 34% of the patients and was associated with female sex, better premorbid intelligence, and a younger age at schizophrenia diagnosis. Functional remission characterized 41% of the patients and 17% of patients met criteria for full recovery both of which were associated with female sex. The clinically re-evaluated patients did not differ from the drop-outs on key register-based variables. Conclusion: We confirm the emerging evidence of a decreasing long-term diagnostic stability of schizophrenia, and a protective role of female sex. The association between premorbid intelligence and symptomatic remission underscores the pertinence of including cognitive deficits in the diagnostic category of schizophrenia. The association between younger age at diagnosis and symptomatic remission may reflect positive effects of early detection or a drift in the interpretation of the diagnostic classification system.

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Correlates of substance use in a large naturalistic cohort of young people with early and emerging psychosis

El-Hage

Cao

Bedi

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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Background Substance use remains a barrier to recovery for young people accessing early intervention services for psychosis. While correlates of use have been explored in populations experiencing a first episode of psychosis (FEP), sample sizes have been small and less research assesses cohorts at ultrahigh risk of psychosis (UHR). Methods This study uses data from a naturalistic cohort including UHR and FEP participants (N = 1252) to elucidate clinical correlates of use in the past 3 months of any illicit substance, amphetamine-type stimulants (ATS), cannabis, and tobacco. Moreover, network analysis based on use of these substances and additionally alcohol, cocaine, hallucinogens, sedatives, inhalants, and opioids was completed. Results Young people with FEP used substances at significantly higher rates than those at UHR. High concurrence of use was seen between substances. In the FEP group, participants who had used any illicit substance, ATS, and/or tobacco had increased positive symptoms and decreased negative symptoms. Young people with FEP who used cannabis had increased positive symptoms. In the UHR group, participants who had used any illicit substance, ATS, and/or cannabis in the past 3 months showed decreased negative symptoms compared to those who had not. Conclusion A distinct clinical picture of more florid positive symptoms and alleviated negative symptoms seen in those who use substances in the FEP group appears muted in the UHR cohort. Treating young people at UHR in early intervention services represents the earliest opportunity to address substance use early to improve outcomes.

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Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up

Cited by 31 publications

References 36 publications

Self-rated disability in first treated episode of psychosis: A 1-year follow-up study

Self-rated disability in first treated episode of psychosis: A 1-year follow-up study

Diagnostic stability and long-term symptomatic and functional outcomes in first-episode antipsychotic-naïve patients with schizophrenia

Correlates of substance use in a large naturalistic cohort of young people with early and emerging psychosis

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