Predictors of acute treatment response in patients with a first episode of non-affective psychosis: Sociodemographics, premorbid and clinical variables

Crespo‐Facorro, Benedicto; Pelayo-Terán, José María; Pérez-Iglesias, Rocí­o; Ramírez-Bonilla, Mariluz; Martínez-Garcia, Obdulia; Pardo-García, Gema; Vázquez‐Barquero, José Luís

doi:10.1016/j.jpsychires.2006.05.002

Cited by 79 publications

(57 citation statements)

References 34 publications

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“…Studies in adults also reported that PsyNOS patients had better outcomes than patients with schizophrenia (Kendler and Walsh 1995;Harrison et al 2001;Jobe and Harrow 2005;Crespo-Facorro et al 2007;Simonsen et al 2010;Crespo-Facorro et al 2013;Diaz et al 2013;Pelayo-Teran et al 2014). However, even in adults, such comparative studies are sparse, and generally have the same limitations as studies in the child and adolescent population; either small sample sizes or lack of differentiation among the different diagnostic first-episode psychosis subgroups.…”

Section: Discussionmentioning

confidence: 97%

Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study

Vernal

Kapoor

Al-Jadiri

et al. 2015

Journal of Child and Adolescent Psychopharmacology

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Objectives: The purpose of this study was to assess differences in the outcomes of youth with schizophrenia-spectrum disorders (SCZ-S) and psychotic disorder not otherwise specified (PsyNOS) during early antipsychotic treatment. Methods: The study was a prospective, naturalistic, inception cohort study of youth £ 19 years old with SCZ-S (schizophrenia, schizoaffective disorder, schizophreniform disorder) or PsyNOS (PsyNOS, brief psychotic disorder) and £ 24 months of lifetime antipsychotic treatment receiving clinician's choice antipsychotic treatment. Baseline demographic, illness and treatment variables, and effectiveness outcomes were compared at 12 weeks last-observation-carried-forward across SCZ-S and PsyNOS patients, adjusting for significantly different baseline variables. Results: Altogether, 130 youth with SCZ-S (n = 42) or PsyNOS (n = 88), mostly antipsychotic naïve (76.9%), were prescribed risperidone (47.7%), olanzapine (19.2%), aripiprazole (14.6%), quetiapine (11.5%), or ziprasidone (6.9%). Compared with those with PsyNOS, SCZ-S youth were older (16.4 -2.1 vs. 14.8 -3.2, p = 0.0040), and less likely to be Caucasian (19.1% vs. 42.5%, p = 0.009). At baseline, SCZ-S patients had significantly higher Clinical Global Impressions-Severity (CGI-S) scores (6.0 -0.9 vs. 5.5 -0.8, p = 0.0018) and lower Children's Global Assessment Scale (CGAS) scores (29.6 -9.2 vs. 36.1 -8.9, p = 0.0002) and were more likely to be in the severely ill CGAS group (i.e., CGAS £ 40). SCZ-S and PsyNOS patients did not differ regarding all-cause discontinuation (40.5 vs. 40.3%. p = 0.49), discontinuation because of adverse effects (12.2% vs. 12.4%, p = 0.97), or nonadherence (29.3% vs. 30.9%, p = 0.88), but somewhat more SCZ-S patients discontinued treatment for inefficacy (19.5% vs. 7.4%, p = 0.063). CGI-S and CGAS scores improved significantly in both diagnostic groups ( p = 0.0001, each). Adjusting for baseline differences, PsyNOS patients experienced significantly better CGI-I improvement (CGI-I) scores ( p = 0.012) and more frequently reached higher categorical CGAS group status ( p = 0.021) than SCZ-S patients. Conclusions: Both youth with SCZ-S and those with PsyNOS experienced significant improvements with clinician's choice antipsychotic treatment. However, treatment discontinuation was common within 12 weeks, with greater inefficacy-related discontinuation in the SCZ-S group, whereas CGI-I and CGAS score-based improvements were greater in the PsyNOS group.

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Section: Discussionmentioning

confidence: 97%

Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study

Vernal

Kapoor

Al-Jadiri

et al. 2015

Journal of Child and Adolescent Psychopharmacology

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“…1 A combination of demographic and clinical variables may predict treatment outcome. 2 However, most studies are conducted in a research setting under controlled conditions which makes it difficult to apply findings to real practice.…”

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confidence: 99%

Acute Treatment Response and Its Predictors in Patients With First-Episode Psychosis in Iran

Tabatabaee

Sharifi

Alaghband-Rad

et al. 2008

Australas Psychiatry

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“…Several previous studies reported similar results. Recently, Schennach-Wolff et al [22] & Crespo-Facorro et al [30] reported that suffering from more severe positive symptoms at baseline predicts achieving early improvement. Previously, Palao et al found that among other clinical and socio-demographic factors, exclusively the severity of positive symptoms predicted a better response to treatment in acute exacerbations [31].…”

Section: Discussionmentioning

confidence: 99%

“…The difference was significant in the investigation sample, and a trend was observable in the replication sample and in the merged sample. Several studies reported that a longer duration of illness predicts a poorer outcome in patients with schizophrenia, maybe reflecting the existence of progressive brain deterioration during the illness that leads to a gradual loss of treatment response [5,30].…”

Section: Discussionmentioning

confidence: 99%

Early Antipsychotic Response Predictors in Schizophrenia: A Naturalistic Study

Porcelli¹

2014

JPCPY

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Studies on schizophrenia failed to find predictors of antipsychotic response, early response apart. We therefore hypothesized that early responders (ERs) could be identified by specific clinical characteristics. Two independent samples of schizophrenic patients were analyzed. Further, analyses were repeated merging the two samples (total=171). Factors associated with early response were also analyzed in patients taking first and second generation antipsychotics (FGAs and SGAs). A t test or a wilcoxon test was used to detect significant differences between ERs and early non responders (ENRs). In the investigation sample ERs had a lower illness duration (p=0.02), suffered from more severe positive (p=0.01), general (p=0.01) and hostile avoidance, that is represented by impulsivity, excitement, hostility and uncooperativeness, (p=0.01); these results were substantially confirmed in the replication sample and in the two samples merged. Results obtained in FGAs-treated patients were similar to those observed in the whole sample. In patients taking SGAs, ERs had more severe positive and depressive symptoms, without differences among other factors. In line with previous findings, the most relevant difference between ERs and ENRs was in the age, ERs being with a natural tendency younger (mean age ERs=39.6, ENRs=49.5). Regarding FGAs/SGAs differences, our results suggest that in ENRs treated with FGAs an increase of antipsychotic drug dosage seems to be of scarce benefit. Switching to a SGA might be of more clinical usefulness.

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Predictors of acute treatment response in patients with a first episode of non-affective psychosis: Sociodemographics, premorbid and clinical variables

Cited by 79 publications

References 34 publications

Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study

Outcome of Youth with Early-Phase Schizophrenia-Spectrum Disorders and Psychosis Not Otherwise Specified Treated with Second-Generation Antipsychotics: 12 Week Results from a Prospective, Naturalistic Cohort Study

Acute Treatment Response and Its Predictors in Patients With First-Episode Psychosis in Iran

Early Antipsychotic Response Predictors in Schizophrenia: A Naturalistic Study

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