Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

Paola Dazzan; Julia Lappin; Margaret Heslin; Kim Donoghue; Ben Lomas; Uli Reininghaus; Adanna Onyejiaka; Timothy Croudace; Peter B. Jones; Robin M. Murray; Paul Fearon; Gillian A.  Doody; Craig Morgan

doi:10.1017/S0033291719001399

Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

Paola Dazzan (Lead / Corresponding author), Julia Lappin, Margaret Heslin, Kim Donoghue, Ben Lomas, Uli Reininghaus, Adanna Onyejiaka, Timothy Croudace, Peter B. Jones, Robin M. Murray, Paul Fearon, Gillian A. Doody, Craig Morgan

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Abstract

BACKGROUND: To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.

METHODS: AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.

RESULTS: At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60-7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02-7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23-6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25-8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61-41.42).

CONCLUSIONS: Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.

Original language	English
Pages (from-to)	1-11
Number of pages	11
Journal	Psychological Medicine
Volume	50
Issue number	9
Early online date	25 Jul 2019
DOIs	https://doi.org/10.1017/S0033291719001399
Publication status	Published - 1 Jul 2020

Keywords

Clinical outcome
functional outcome
psychosis
remission
schizophrenia

ASJC Scopus subject areas

Applied Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1017/S0033291719001399Licence: CC BY

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© Cambridge University Press 2019. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited
Final published version, 209 KBLicence: CC BY

Cite this

@article{16a940704b644a9a9d1ad2d086971e5d,

title = "Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis",

abstract = "BACKGROUND: To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.METHODS: AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.RESULTS: At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60-7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02-7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23-6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25-8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61-41.42).CONCLUSIONS: Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.",

keywords = "Clinical outcome, functional outcome, psychosis, remission, schizophrenia",

author = "Paola Dazzan and Julia Lappin and Margaret Heslin and Kim Donoghue and Ben Lomas and Uli Reininghaus and Adanna Onyejiaka and Timothy Croudace and Jones, {Peter B.} and Murray, {Robin M.} and Paul Fearon and Doody, {Gillian A.} and Craig Morgan",

note = "This work was supported by UK Medical Research Council (ref: G0500817) and the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley Foundation Trust (SLaM) and King{\textquoteright}s College London. ",

year = "2020",

month = jul,

day = "1",

doi = "10.1017/S0033291719001399",

language = "English",

volume = "50",

pages = "1--11",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

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TY - JOUR

T1 - Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

AU - Dazzan, Paola

AU - Lappin, Julia

AU - Heslin, Margaret

AU - Donoghue, Kim

AU - Lomas, Ben

AU - Reininghaus, Uli

AU - Onyejiaka, Adanna

AU - Croudace, Timothy

AU - Jones, Peter B.

AU - Murray, Robin M.

AU - Fearon, Paul

AU - Doody, Gillian A.

AU - Morgan, Craig

N1 - This work was supported by UK Medical Research Council (ref: G0500817) and the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley Foundation Trust (SLaM) and King’s College London.

PY - 2020/7/1

Y1 - 2020/7/1

N2 - BACKGROUND: To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.METHODS: AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.RESULTS: At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60-7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02-7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23-6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25-8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61-41.42).CONCLUSIONS: Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.

AB - BACKGROUND: To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.METHODS: AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.RESULTS: At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60-7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02-7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23-6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25-8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61-41.42).CONCLUSIONS: Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.

KW - Clinical outcome

KW - functional outcome

KW - psychosis

KW - remission

KW - schizophrenia

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U2 - 10.1017/S0033291719001399

DO - 10.1017/S0033291719001399

M3 - Article

C2 - 31364523

SN - 0033-2917

VL - 50

SP - 1

EP - 11

JO - Psychological Medicine

JF - Psychological Medicine

IS - 9

ER -

Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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