Predicting 1-year risk for relapse in patients who have discontinued or continued quetiapine after remission from first-episode psychosis

Rates and predictors of disengagement of patients with first‐episode psychosis from the early intervention service for sychosis service (EASY) covering 15 to 64 years of age in Hong Kong

“…One of the key factors related to relapse and poor prognosis is treatment discontinuation (Hui et al, 2013. Therefore, better engagement of patients is an important component of the early intervention service.…”

Perinatal psychosis in mothers with a history of major depressive disorder

“…While Di Florio et al used stringent clinical diagnostic criteria to determine the presence of psychosis, we applied the PANSS. The PANSS is not a diagnostic instrument, but specific cut-off scores for five of its items have previously been used (in the context of evaluating relapse rates in patients with a history of first episode psychosis) to assess presence of psychosis (Hui et al 2013, Chen et al 2010. Though each cut off is anchored on the identification of clearly defined symptoms that have been deemed to be clinically significant (see Table 2), they have not been specifically validated to assess psychosis in women with a history of MDD, and it is important to consider whether they could potentially be confounded by the perinatal period.…”

“…Five of the PANSS items can be used to assess the presence and severity of psychosis, using specific cut off scores for each of these items (delusions ≥ 3, conceptual disorganization ≥ 4, hallucinations ≥ 3, suspiciousness ≥ 5, unusual thought content ≥ 4). This approach was used to establish the presence of relapse of psychosis in a randomized clinical trial of relapse prevention in first episode psychosis (Hui et al 2013Chen et al 2010 All PANSS raters participated in training and underwent inter-rater reliability testing throughout the course of the study. Krippendorf's alpha for inter-rater reliability was calculated for each of the five PANSS items (delusions, conceptual disorganization, hallucinations, suspiciousness, and unusual thought content).…”

Early medication discontinuation in first episode schizophrenia – beneficial or risky?

“…The few studies that aimed at identifying predictors for a successful drug discontinuation after a first episode in schizophrenia are mostly based on observational designs and often revealed rather general results, like (better) premorbid social adjustment or living in Western European Countries (vs. Eastern European; 44), not having been hospitalized the previous 5 years (50) or not living with family and no family history of psychosis (both 0.05<p<0.1; Mayoral-van Son et al 49). Using the data of an RCT comparing MT and drug discontinuation (masked with placebo) Hui et al (37) identified as significant predictors for (mild positive) symptom return: a diagnosis of schizophrenia, poorer semantic fluency performance, higher spontaneous eye blinking rate, a higher SANS score, and the presence of premorbid schizoid-schizotypal traits. Based on the RCT of MT vs.…”