Relapse prevention and remission attainment in first-episode non-affective psychosis. A randomized, controlled 1-year follow-up comparison of haloperidol, risperidone and olanzapine

Predicting relapse after a first episode of non-affective psychosis: A three-year follow-up study

“…The cumulative rate for a first relapse increases progressively during the first years (from 16.2% by the end of the 1-year follow-up to 81.9% by the end of the 5-year follow-up) (Robinson et al, 1999). Lower relapse rates are observed in first-episode patients who were followed up in specialized early intervention services, compared to those in routine care (Craig et al, 2004;Crespo-Facorro et al, 2011;Linszen et al, 1998 a,b;Malla et al, 2008;Petersen et al, 2005). Adherence to medication has been shown as the biggest predictor of relapse after a first episode of schizophrenia (Gilbert et al, 1995;Malla et al, 2008;Novak-Grubic and Tavcar, 2002;Robinson et al, 1999;Üçok et al, 2006).…”

“…Comorbid diagnosis of substance abuse (Malla et al, 2008), poor premorbid functioning (Robinson et al, 1999;Üçok et al, 2006), lower educational attainment (Geddes et al, 1994), symptoms of depression (Geddes et al, 1994) and a lower severity of psychopathology at baseline (Altamura et al, 2001) seem to enhance the risk of relapse during the early years of the illness. In first-episode psychosis, second generation antipsychotics were described as being superior to first generation antipsychotics in preventing relapses (Schooler, 2003;Üçok et al, 2006), although other recent studies failed to observe the benefits of second generation over first generation antipsychotics (Crespo-Facorro et al, 2011).…”

Determinants of adherence to treatment in first-episode psychosis: a comprehensive review

“…Subjective measures included selfreporting, ratings by clinicians or other treatment providers, consensus of the whole treatment team, family members, or a combination of the above. 16,[41][42][43][44] Objective measures of medication adherence included plasma levels of antipsychotic medication and/or mood stabilizers, pill counts, and prescription renewals. [45][46][47] A frequent method to measure medication adherence subjectively was to consider patients nonadherent when they failed to take medication for a period of 1 or 2 weeks.…”

“…16,60 Effectiveness In a cohort study by Steger et al 52 of patients with a diagnosis of either affective or non-affective psychosis, remission of negative symptoms by the third month of treatment was associated with nonadherence to medication, but a rapid remission of positive symptoms showed no relationship with adherence. This means that even patients who seem to benefit from medication could be at a higher risk of nonadherence.…”

“…[11][12][13][14][15] The risk of relapse after the FEP is high, and the most robust predictor of this occurrence is nonadherence to medication. 3,[16][17][18] Tiihonen et al 19 performed a nationwide cohort study of 2,588 patients hospitalized for the first time with schizophrenia in Finland and found that only a minority of patients adhered to their initial antipsychotic during the first 60 days after discharge. Individuals nonadherent to medication have higher rates of hospital readmission, lower rates of symptom remission, and lower quality of life.…”