Symptomatic and functional remission in patients with first-episode psychosis

Acta Psychiatr Scand. 2012 Oct;126(4):282-9. doi: 10.1111/j.1600-0447.2012.01883.x. Epub 2012 May 23.

Abstract

Objective: For patients suffering from psychotic disorders and their caregivers, 'recovery' remains important. Our study aims to examine the rates of both symptomatic and functional remission in first-episode psychosis (FEP) patients at 2 years and identify sociodemographic and clinical factors associated with recovery.

Method: In this naturalistic study, all consecutive FEP patients presenting to an early psychosis intervention programme were recruited. Symptomatic remission was defined by the Schizophrenia Working Group's criteria; functional remission was defined as a Global Assessment of Functioning (GAF) disability score of ≥61 with engagement in age-appropriate vocation. Simple and multiple logistic regressions using stepwise method were used.

Results: Out of 1175 patients, 636 (54.1%) met criteria for symptomatic remission, 686 (58.4%) for functional remission, while 345 (29.4%) met for both. Multiple logistic regression revealed female gender (OR 1.47; 95%CI, 1.12-1.93), those married (OR 1.49; 95%CI, 1.02-2.18), younger age (OR 0.98; 95%CI, 0.95-0.99), tertiary education (OR 1.56; 95%CI, 1.02-2.38), shorter DUP (OR 0.99; 95%CI, 0.98-0.99), lower baseline PANSS negative scores (OR 0.97; 95%CI, 0.95-0.99), and early response at month 3 (OR 1.78; 95%CI, 1.31-2.42), as significant predictors of recovery at year 2.

Conclusion: Our results indicate that strategies to reduce DUP and achieve early response could improve remission rates in FEP patients.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Early Medical Intervention
  • Educational Status
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Marital Status
  • Prognosis
  • Psychotic Disorders / physiopathology
  • Psychotic Disorders / therapy*
  • Recovery of Function
  • Remission Induction
  • Risk Factors
  • Schizophrenia / physiopathology
  • Schizophrenia / therapy*
  • Sex Factors
  • Treatment Outcome