The Iowa Longitudinal Study of Recent Onset Psychosis: One-year follow-up of first episode patients

Gupta, Sanjay; Andreasen, Nancy C.; Arndt, Stephan; Flaum, Michael; Hubbard, William C.; Ziebell, Steven

doi:10.1016/s0920-9964(96)00078-3

Cited by 104 publications

(69 citation statements)

References 44 publications

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“…Mason et al, 1995;Gupta et al, 1997;Singh et al, 2000). Evidence suggests that employment can lead to improvements in outcome for people diagnosed with schizophrenia through increasing self-esteem, alleviating psychiatric symptoms and reducing dependency (Cook & Razzano, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Poor employment outcomes are a constant finding in research on first-episode psychosis (e.g. Mason et al, 1995;Gupta et al, 1997;Singh et al, 2000), with employment rates for people with longer-term schizophrenia reported to be as low as 4% (Perkins & Rinaldi, 2002). O'Brien et al (2003), in their study of the effects of training clinical staff in the practice of evidence-based supported employment without a vocational worker integrated into the team, found that only 6% of people achieved open employment Rinaldi et al Supported employment in first-episode psychosis original papers thereafter, which compares with a figure of 11% found in a naturalistic study following people in a vocational rehabilitation programme (Reker et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

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What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

Rinaldi

McNeil²,

Firn³

et al. 2004

Psychiatr. bull.

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Aims and MethodTo examine the effectiveness of integrating evidence-based supported employment into an early intervention service for young people with first-episode psychosis. Demographic, clinical and vocational data were collected over a 12-month period to evaluate the effect on vocational outcomes at 6 months and 12 months of the employment of a vocational specialist, and to assess model fidelity.ResultsFollowing vocational profiling and input from the vocational specialist and the team, there were significant increases in the proportion of clients engaged in work or educational activity over the first 6 months of the intervention, and in a subsample over a second 6-month period. The evidence-based Supported Employment Fidelity Scale was used to measure the degree of implementation, which scored 71, signifying ‘good implementation’.Clinical ImplicationsThe results suggest that implementing evidence-based supported employment within an early intervention service increases employment and education opportunities for patients within the service.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

Rinaldi

McNeil²,

Firn³

et al. 2004

Psychiatr. bull.

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“…Symptoms of schizophrenia are divided into three main clusters: positive symptoms, such as paranoia and agitation; negative symptoms, such as anhedonia and emotional withdrawal; and disorganized symptoms, such as formal thought disorder and bizarre behavior (Grube et al, 1998). Positive and disorganized symptoms typically fluctuate in severity over the course of the illness and increase during times of psychotic decompensation (Arndt et al, 1995;Gupta et al, 1997). In contrast, negative symptoms and associated cognitive deficits remain more stable and contribute particularly to poor long-term outcome (Gold et al, 1999;O'Leary et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Subchronic Continuous Phencyclidine Administration Potentiates Amphetamine-Induced Frontal Cortex Dopamine Release

Balla

Sershen

Serra

et al. 2003

Neuropsychopharmacol

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Functional dopaminergic hyperactivity is a key feature of schizophrenia. Etiology of this dopaminergic hyperactivity, however, is unknown. We have recently demonstrated that subchronic phencyclidine (PCP) treatment in rodents induces striatal dopaminergic hyperactivity similar to that observed in schizophrenia. The present study investigates the ability of PCP to potentiate amphetamine-induced dopamine release in prefrontal cortex (PFC) and nucleus accumbens (NAc) shell. Prefrontal dopaminergic hyperactivity is postulated to underlie cognitive dysfunction in schizophrenia. In contrast, the degree of NAc involvement is unknown and recent studies have suggested that PCP-induced hyperactivity in rodents may correlate with PFC, rather than NAc, dopamine levels. Rats were treated with 5-20 mg/kg/day PCP for 3-14 days by osmotic minipump. PFC and NAc dopamine release to amphetamine challenge (1 mg/kg) was monitored by in vivo microdialysis and HPLC-EC. Doses of 10 mg/kg/day and above produced serum PCP concentrations (50-150 ng/ml) most associated with PCP psychosis in humans. PCP-treated rats showed significant, dose-dependent enhancement in amphetamine-induced dopamine release in PFC but not NAc, along with significantly enhanced locomotor activity. Enhanced response was observed following 3-day, as well as 14-day, treatment and resolved within 4 days of PCP treatment withdrawal. These findings support the concept that endogenous NMDA receptor dysfunction could account for the pattern of dopaminergic dysfunction observed in schizophrenia, and suggest that even short duration abuse of PCP-like agents may greatly potentiate behavioral effects of psychostimulants in drug abuse situations. Finally, these studies provide a model system in which to evaluate effects of potential psychotherapeutic agents.

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“…The complexity and risk of confounding under such con-ditions has encouraged prospective studies of firstepisode patients in early or prodromal phases of illness. Most first-episode studies involve patients diagnosed with early (Jones & Tarrant, 1999;McGorry et al, 2000;Cannon et al, 2001;Gaebel et al, 2001;Hollis 2003), or established schizophrenia (Kane et al, 1982;Biehl et al, 1986;Schubart et al, 1986;McCreadie et al, 1989;Johnstone et al, 1990;Tohen et al, 1990b;1992a;1996;Tohen 1991;Leff et al, 1992;Ram et al, 1992;Ventura et al, 1992;Lieberman et ai, 1993;Bromet et al, 1996;Varma et al, 1996;Craig et al, 1997;Gupta et al, 1997;Lay et al, 1997). There have been far fewer first-episode follow-up studies of patients diagnosed with bipolar disorder (Tohen et al, 1990b(Tohen et al, , 2000aFennig et al, 1996;Strakowski et al, 1998;Conus et al, 2004;Schimmelmann et al, 2005), or other types of psychotic disorders (Pillmann et ai, 2002;Schimmelmann et ai, 2005;Abe et ai, 2006;Emsley et ai, 2006;2007).…”

Section: Longitudinal Studies Of Psychotic Disordersmentioning

confidence: 99%

Longitudinal research on bipolar disorders

Salvatore¹,

Tohen²,

Khalsa³

et al. 2007

Epidemiol Psichiatr Soc

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Abstract. Longitudinal assessment of the course of major psychiatric disorders has been advanced by studies from onset, but only rarely have large numbers of patients with a range of psychotic and major affective disorders been studied simultaneously and systematically from illness-onset. The decade-long McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research has systematically followed-up large numbers of patients with DSM-IV bipolar or psychotic disorders from firsthospitalization. Major findings among patients with bipolar I disorder include: [a] full functional recovery from initial episodes was uncommon, and full symptomatic recovery, much slower than early syndromal recovery; [b] risks of relapse, recurrence, and switching were very high in the first two years; [c] most early morbidity was depressive-dysphoric, as reported in mid-course; [d] initial depression or mixed-states predicted more later depressive and overall morbidity, whereas initial mania or psychosis predicted later mania and a better prognosis; [e] based on within-subject modeling, most patients did not show progressive cycling over time, and illness-course was rather chaotic within and among patients; [f] treatment-latency or episode-counts were unassociated with responsiveness to long-term mood-stabilizing treatment; [g] very high rates of suicidal behavior and accidents occurred early; [h] early substance-use comorbidity associated with anxiety; [i] factor-analysis of prodromal symptoms predicted bipolar disorder much better than non-affective psychotic disorders. Project findings indicate that the course of bipolar I disorder is much less favorable than had been believed formerly, despite clinical treatment with modern mood-stabilizing and other treatments.

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The Iowa Longitudinal Study of Recent Onset Psychosis: One-year follow-up of first episode patients

Cited by 104 publications

References 44 publications

What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

Subchronic Continuous Phencyclidine Administration Potentiates Amphetamine-Induced Frontal Cortex Dopamine Release

Longitudinal research on bipolar disorders

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