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Predictors of 10-year outcome of first-episode psychosis.
Psychol Med. 2009 Sep; 39(9):1447-56.PM

Abstract

BACKGROUND

Predictors of outcome for psychosis are poorly understood. Duration of untreated psychosis (DUP) appears to predict short-term outcome although its medium- to long-term role remains unclear. Neurodevelopmental indices such as pre-morbid function and/or neurological soft signs may predict longer-term outcome. We aimed to assess the impact of a range of clinical and demographic variables on long-term outcome of a geographically defined, epidemiological first-episode psychosis cohort.

METHOD

A 10-year follow-up was undertaken of a consecutively presenting sample of 109 cases of first-episode psychosis aged 16-50 years. Baseline assessments included positive, negative and depression symptoms, DUP, neurological soft signs and pre-morbid functioning. Multi-dimensional outcomes were assessed blind to baseline data.

RESULTS

All participants were traced at a mean of 10.5 years post-index admission: 11 had died, 10 from non-natural causes. Of the surviving cases, 70% were comprehensively re-assessed by interview. Summary data on the remainder were collected from their family practitioner and chart review. Poor 10-year outcomes were predicted independently by poor pre-morbid functioning, baseline negative symptoms and longer DUP. The same measures, plus neurological soft signs, appeared to predict outcomes in a DSM-IV schizophrenia/schizo-affective subgroup.

CONCLUSIONS

Poor pre-morbid functioning, baseline symptoms, DUP and neurological soft signs at onset independently predict poor long-term outcome in first-episode psychosis.

Authors+Show Affiliations

Division of Psychiatry, University of Manchester, Manchester, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19187566

Citation

White, C, et al. "Predictors of 10-year Outcome of First-episode Psychosis." Psychological Medicine, vol. 39, no. 9, 2009, pp. 1447-56.
White C, Stirling J, Hopkins R, et al. Predictors of 10-year outcome of first-episode psychosis. Psychol Med. 2009;39(9):1447-56.
White, C., Stirling, J., Hopkins, R., Morris, J., Montague, L., Tantam, D., & Lewis, S. (2009). Predictors of 10-year outcome of first-episode psychosis. Psychological Medicine, 39(9), 1447-56. https://doi.org/10.1017/S003329170800514X
White C, et al. Predictors of 10-year Outcome of First-episode Psychosis. Psychol Med. 2009;39(9):1447-56. PubMed PMID: 19187566.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of 10-year outcome of first-episode psychosis. AU - White,C, AU - Stirling,J, AU - Hopkins,R, AU - Morris,J, AU - Montague,L, AU - Tantam,D, AU - Lewis,S, Y1 - 2009/02/03/ PY - 2009/2/4/entrez PY - 2009/2/4/pubmed PY - 2009/10/21/medline SP - 1447 EP - 56 JF - Psychological medicine JO - Psychol Med VL - 39 IS - 9 N2 - BACKGROUND: Predictors of outcome for psychosis are poorly understood. Duration of untreated psychosis (DUP) appears to predict short-term outcome although its medium- to long-term role remains unclear. Neurodevelopmental indices such as pre-morbid function and/or neurological soft signs may predict longer-term outcome. We aimed to assess the impact of a range of clinical and demographic variables on long-term outcome of a geographically defined, epidemiological first-episode psychosis cohort. METHOD: A 10-year follow-up was undertaken of a consecutively presenting sample of 109 cases of first-episode psychosis aged 16-50 years. Baseline assessments included positive, negative and depression symptoms, DUP, neurological soft signs and pre-morbid functioning. Multi-dimensional outcomes were assessed blind to baseline data. RESULTS: All participants were traced at a mean of 10.5 years post-index admission: 11 had died, 10 from non-natural causes. Of the surviving cases, 70% were comprehensively re-assessed by interview. Summary data on the remainder were collected from their family practitioner and chart review. Poor 10-year outcomes were predicted independently by poor pre-morbid functioning, baseline negative symptoms and longer DUP. The same measures, plus neurological soft signs, appeared to predict outcomes in a DSM-IV schizophrenia/schizo-affective subgroup. CONCLUSIONS: Poor pre-morbid functioning, baseline symptoms, DUP and neurological soft signs at onset independently predict poor long-term outcome in first-episode psychosis. SN - 1469-8978 UR - https://www.unboundmedicine.com/medline/citation/19187566/Predictors_of_10_year_outcome_of_first_episode_psychosis_ L2 - https://www.cambridge.org/core/product/identifier/S003329170800514X/type/journal_article DB - PRIME DP - Unbound Medicine ER -