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A five year diagnostic follow-up of 1,840 patients after a first episode non-schizophrenia and non-affective psychosis.
Schizophr Res. 2013 Oct; 150(1):205-10.SR

Abstract

OBJECTIVE

It is not clear which patients with a first psychotic episode will develop schizophrenia. We performed a diagnostic follow-up of patients treated for a first time non-affective, non-schizophrenia psychosis and explored potential predictors of a subsequent schizophrenia or schizoaffective diagnosis.

METHODS

This register-based cohort study comprises individuals born between 1973 and 1978 in Sweden, with a first hospital-treated psychosis excluding schizophrenia, schizoaffective disorder, bipolar disorder and depressive disorder with psychotic symptoms (n=1840). The patients were followed for five years regarding subsequent diagnoses. Psychiatric, social, family history of psychiatric illness, premorbid intellectual level, head injuries and obstetrical complications were investigated by logistic regression as predictors of schizophrenia or schizoaffective diagnosis.

RESULTS

During the follow-up, 18% were diagnosed with schizophrenia or schizoaffective disorder, 5% were diagnosed with bipolar disorder, whereas 29% were not re-admitted to a psychiatric clinic. Patients with a first-degree relative hospitalized for schizophrenia and/or bipolar disorder had an increased risk of subsequent diagnosis for schizophrenia or schizoaffective disorder (odds ratio 1.9 and 95% confidence interval 1.1 to 3.0)), whereas previous severe criminality was associated with a decreased risk (odds ratio 0.5, 95% confidence interval 0.3-0.8).

CONCLUSION

Diagnostic outcome was diverse after a first non-schizophrenia and non-affective psychosis. Family history of severe mental illness and no previous conviction for severe criminality were the strongest risk factors for a future schizophrenia or schizoaffective diagnosis.

Authors+Show Affiliations

Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Statistics, Monitoring and Evaluation, National Board of Health and Welfare, Stockholm, Sweden.No 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

23899998

Citation

Björkenstam, E, et al. "A Five Year Diagnostic Follow-up of 1,840 Patients After a First Episode Non-schizophrenia and Non-affective Psychosis." Schizophrenia Research, vol. 150, no. 1, 2013, pp. 205-10.
Björkenstam E, Björkenstam C, Hjern A, et al. A five year diagnostic follow-up of 1,840 patients after a first episode non-schizophrenia and non-affective psychosis. Schizophr Res. 2013;150(1):205-10.
Björkenstam, E., Björkenstam, C., Hjern, A., Reutfors, J., & Bodén, R. (2013). A five year diagnostic follow-up of 1,840 patients after a first episode non-schizophrenia and non-affective psychosis. Schizophrenia Research, 150(1), 205-10. https://doi.org/10.1016/j.schres.2013.07.011
Björkenstam E, et al. A Five Year Diagnostic Follow-up of 1,840 Patients After a First Episode Non-schizophrenia and Non-affective Psychosis. Schizophr Res. 2013;150(1):205-10. PubMed PMID: 23899998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A five year diagnostic follow-up of 1,840 patients after a first episode non-schizophrenia and non-affective psychosis. AU - Björkenstam,E, AU - Björkenstam,C, AU - Hjern,A, AU - Reutfors,J, AU - Bodén,R, Y1 - 2013/07/27/ PY - 2013/02/18/received PY - 2013/06/14/revised PY - 2013/07/03/accepted PY - 2013/8/1/entrez PY - 2013/8/1/pubmed PY - 2014/5/9/medline KW - Cohort study KW - Diagnostic follow-up KW - Population based KW - Predictors KW - Psychosis KW - Schizophrenia SP - 205 EP - 10 JF - Schizophrenia research JO - Schizophr Res VL - 150 IS - 1 N2 - OBJECTIVE: It is not clear which patients with a first psychotic episode will develop schizophrenia. We performed a diagnostic follow-up of patients treated for a first time non-affective, non-schizophrenia psychosis and explored potential predictors of a subsequent schizophrenia or schizoaffective diagnosis. METHODS: This register-based cohort study comprises individuals born between 1973 and 1978 in Sweden, with a first hospital-treated psychosis excluding schizophrenia, schizoaffective disorder, bipolar disorder and depressive disorder with psychotic symptoms (n=1840). The patients were followed for five years regarding subsequent diagnoses. Psychiatric, social, family history of psychiatric illness, premorbid intellectual level, head injuries and obstetrical complications were investigated by logistic regression as predictors of schizophrenia or schizoaffective diagnosis. RESULTS: During the follow-up, 18% were diagnosed with schizophrenia or schizoaffective disorder, 5% were diagnosed with bipolar disorder, whereas 29% were not re-admitted to a psychiatric clinic. Patients with a first-degree relative hospitalized for schizophrenia and/or bipolar disorder had an increased risk of subsequent diagnosis for schizophrenia or schizoaffective disorder (odds ratio 1.9 and 95% confidence interval 1.1 to 3.0)), whereas previous severe criminality was associated with a decreased risk (odds ratio 0.5, 95% confidence interval 0.3-0.8). CONCLUSION: Diagnostic outcome was diverse after a first non-schizophrenia and non-affective psychosis. Family history of severe mental illness and no previous conviction for severe criminality were the strongest risk factors for a future schizophrenia or schizoaffective diagnosis. SN - 1573-2509 UR - https://www.unboundmedicine.com/medline/citation/23899998/A_five_year_diagnostic_follow_up_of_1840_patients_after_a_first_episode_non_schizophrenia_and_non_affective_psychosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920-9964(13)00355-1 DB - PRIME DP - Unbound Medicine ER -