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

Research output: Contribution to journalArticle

15 Downloads (Pure)

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 languageEnglish
Pages (from-to)1-11
Number of pages11
JournalPsychological Medicine
Early online date25 Jul 2019
DOIs
Publication statusE-pub ahead of print - 25 Jul 2019

Fingerprint

Psychotic Disorders
Bipolar Disorder
Demography
Outcome Assessment (Health Care)
Depression
Population

Keywords

  • Clinical outcome
  • functional outcome
  • psychosis
  • remission
  • schizophrenia

Cite this

Dazzan, P., Lappin, J., Heslin, M., Donoghue, K., Lomas, B., Reininghaus, U., ... Morgan, C. (2019). Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis. Psychological Medicine, 1-11. https://doi.org/10.1017/S0033291719001399
Dazzan, Paola ; Lappin, Julia ; Heslin, Margaret ; Donoghue, Kim ; Lomas, Ben ; Reininghaus, Uli ; Onyejiaka, Adanna ; Croudace, Timothy ; Jones, Peter B. ; Murray, Robin M. ; Fearon, Paul ; Doody, Gillian A. ; Morgan, Craig. / Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis. In: Psychological Medicine. 2019 ; pp. 1-11.
@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’s College London.",
year = "2019",
month = "7",
day = "25",
doi = "10.1017/S0033291719001399",
language = "English",
pages = "1--11",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",

}

Dazzan, P, Lappin, J, Heslin, M, Donoghue, K, Lomas, B, Reininghaus, U, Onyejiaka, A, Croudace, T, Jones, PB, Murray, RM, Fearon, P, Doody, GA & Morgan, C 2019, 'Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis', Psychological Medicine, pp. 1-11. https://doi.org/10.1017/S0033291719001399

Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis. / Dazzan, Paola (Lead / Corresponding author); Lappin, Julia; Heslin, Margaret; Donoghue, Kim; Lomas, Ben; Reininghaus, Uli; Onyejiaka, Adanna; Croudace, Timothy; Jones, Peter B.; Murray, Robin M.; Fearon, Paul; Doody, Gillian A. ; Morgan, Craig.

In: Psychological Medicine, 25.07.2019, p. 1-11.

Research output: Contribution to journalArticle

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 - 2019/7/25

Y1 - 2019/7/25

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

UR - http://www.scopus.com/inward/record.url?scp=85070080529&partnerID=8YFLogxK

U2 - 10.1017/S0033291719001399

DO - 10.1017/S0033291719001399

M3 - Article

SP - 1

EP - 11

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

ER -