Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

Yoshimura, Bunta; Sakamoto, Shinji; Sato, Kojiro; Takaki, Manabu; Yamada, Norihito

doi:10.1111/eip.12531

Cited by 8 publications

(7 citation statements)

References 63 publications

(81 reference statements)

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“…Other predictors of non-response and resistance in this study were the younger age of onset and the diagnosis of schizophrenia. Yoshimura et al (76) confirmed the previous results about the influence of negative symptoms on resistance in 131 patients with schizophrenia. Investigation conducted by Downs et al (77) in 638 subjects with early-onset psychosis highlighted the importance of the negative symptomatology in predicting response also in particular populations such as children and adolescents.…”

Section: Resultssupporting

confidence: 61%

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Predictive Factors of Treatment Resistance in First Episode of Psychosis: A Systematic Review

2019

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Background: Clinical and functional outcome improvement in psychotic disorders is a challenge for the investigators. Recent advances offered opportunities for ameliorating the course of the illness during its early stages and for identifying treatment-resistant patients. Patients who had not response to two different antipsychotics, administered at correct doses for a sufficient period, can be operationally considered treatment-resistant. Available evidence suggested that the response's trajectory to the antipsychotic treatment revealed that a small proportion of subjects are poor responders (8.2%), the majority of patients have a moderate response (76.4%), and only 15.4% can be considered rapid responders with the greatest magnitude of response. Patients with first episode of psychosis generally obtain a more favorable response profile. Nevertheless, in around 25% of these patients symptoms of psychosis persist with a worse long-term course of illness. Objectives: The aim of this review is to report current evidences on the main predictors of treatment non-response in patients at early stage of psychosis. Methods: We used a specific string that guaranteed a high sensitive search in pubmed. We included the following types of publications: randomized-controlled trials, observational studies, longitudinal studies, retrospective studies, case-control studies, open-label investigations, cohort studies, and reviews. Publications must concern predictors of treatment resistance in early psychosis. Results: Forty-seven records were included: 5 reviews, 3 meta-analyses, 22 longitudinal studies, 2 retrospective studies, 1 naturalistic study, 6 randomized controlled trials, 2 open-label studies, 2 case-control studies, 4 cohort studies, 2 retrospective studies. Several factors were identified as predictors of treatment resistance: lower premorbid functioning; lower level of education; negative symptoms from first psychotic episode; comorbid substance use; younger age at onset; lack of early response; non-adherence to treatment; and longer duration of untreated psychosis. The role of gender and marital status is still controversial. More evidences are needed about neurobiological, genetic, and neuroimaging factors. Conclusions: The identification of specific predictive factors of treatment resistance in patients with first episode of psychosis ameliorates the quality of clinical management of these patients in the critical early phase of schizophrenia.

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Section: Resultssupporting

confidence: 61%

“…In line with previous findings, Demjaha et al (8) reported that longer DUP predicted treatment resistance. Moreover, Yoshimura et al (76) found that a shorter DUP predicted favorable response and remission in FEP patients with schizophrenia.…”

Section: Resultsmentioning

confidence: 99%

Predictive Factors of Treatment Resistance in First Episode of Psychosis: A Systematic Review

2019

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“…As in previous studies (Chan et al, 2021;Díaz et al, 2013;Friis et al, 2016;Lally et al, 2016;Smart et al, 2021), earlier age of onset of psychosis, poor premorbid adjustment, low educational level, being male and being single were identified as risk factors in clinical treatment resistance, although the effect of gender on treatment resistance has not been confirmed in other studies (Crespo-Facorro et al, 2013a;A Demjaha et al, 2017;Wimberley et al, 2016). In terms of clinical predictors, higher severity negative symptoms on FEP had also been associated with higher rates of resistance to treatment (Bozzatello et al, 2019;A Demjaha et al, 2017;Yoshimura et al, 2017). These findings, in line with previous studies, suggest that treatment-resistant schizophrenia could be a different subtype of schizophrenia.…”

Section: Discussionmentioning

confidence: 71%

Naturalistic study on the use of clozapine in the early phases of non-affective psychosis: A 10-year follow-up study in the PAFIP-10 cohort

Moreno-Sancho

Ruíz

Vázquez-Bourgon

et al. 2022

Journal of Psychiatric Research

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“…We excluded 8061 at title and abstract level. A total of 212 articles were reviewed at full-text level, with 12 studies meeting the criteria for inclusion, [20][21][22][23][24][25][26][27][28][29][30][31] of which one was an unpublished data-set. 28 No additional studies were identified through hand-searching.…”

Section: Study Selectionmentioning

confidence: 99%

“…Nine studies used prospective data collection, with the other three being collected retrospectively. Only two studies provided data on involuntary treatment status, 21,31 precluding meaningful sensitivity analysis on this variable.…”

Section: Study Characteristicsmentioning

confidence: 99%

Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis

et al. 2021

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Background Treatment-resistant schizophrenia (TRS) is associated with high levels of functional impairment, healthcare usage and societal costs. Cross-sectional studies may overestimate TRS rates because of selection bias. Aims We aimed to quantify TRS rates by using first-episode cohorts to improve resource allocation and clozapine access. Method We undertook a systematic review of TRS rates among people with first-episode psychosis and schizophrenia, with a minimum follow-up of 8 weeks. We searched PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Database of Systematic Reviews, and meta-analysed TRS rates from included studies. Results Twelve studies were included, totalling 11 958 participants; six studies were of high quality. The rate of TRS was 22.8% (95% CI 19.1–27.0%, P < 0.001) among all first-episode cohorts and 24.4% (95% CI 19.5–30.0%, P < 0.001) among first-episode schizophrenia cohorts. Subgroup sensitivity analyses by location of recruitment, TRS definition, study quality, time of data collection and retrospective versus prospective data collection did not lead to statistically significant differences in heterogeneity. In a meta-regression, duration of follow-up and percentage drop-out did not significantly affect the overall TRS rate. Men were 1.57 times more likely to develop TRS than women (95% CI 1.11–2.21, P = 0.010). Conclusions Almost a quarter of people with first-episode psychosis or schizophrenia will develop TRS in the early stages of treatment. When including people with schizophrenia who relapse despite initial response and continuous treatment, rates of TRS may be as high as a third. These high rates of TRS highlight the need for improved access to clozapine and psychosocial supports.

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Predictors of remission during acute treatment of first‐episode schizophrenia patients involuntarily hospitalized and treated with algorithm‐based pharmacotherapy: Secondary analysis of an observational study

Abstract: The importance of early intervention and specific and adequate treatments of negative symptoms is highlighted.

Cited by 8 publications

References 63 publications

Predictive Factors of Treatment Resistance in First Episode of Psychosis: A Systematic Review

Predictive Factors of Treatment Resistance in First Episode of Psychosis: A Systematic Review

Naturalistic study on the use of clozapine in the early phases of non-affective psychosis: A 10-year follow-up study in the PAFIP-10 cohort

Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis

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