Tags

Type your tag names separated by a space and hit enter

Prodromal symptoms and remission following first episode psychosis.
Schizophr Res. 2015 Oct; 168(1-2):30-6.SR

Abstract

INTRODUCTION

Describing the trajectory of prodromal symptoms has obvious appeal in supporting advances towards sub-clinical intervention. Identifying clinical phenomena associated with unfavourable illness outcomes could have greater significance in explaining some heterogeneity within and between psychotic disorders and advancing understanding of pre-psychotic typologies. Few studies have assessed the continuity, if any, between prodromal phases and illness outcome one year after treatment.

METHODS

We assessed 375 people with first-episode psychosis (FEP) and 215 (57.4%) were seen approximately one year later. We performed factor analysis on prodromal symptom items obtained by interview with families and participants and identified a five-factor solution. We determined whether these factors predicted non-remission from psychosis in the presence of other factors that may predict outcome including premorbid adjustment, duration of prodrome and untreated psychosis (DUP), baseline symptoms and DSM-IV diagnoses. We used random forest classification to predict the most important variables and logistic regression to identify specific predictors.

RESULTS

We identified five prodromal symptom factors comprising Negative Symptoms, General Psychopathology, Reality Distortion, Strange Ideas and Irritability. Prodromal symptoms did not predict a greater risk of non-remission with the exception of Irritability and this factor was also associated with earlier age at onset, being male and a diagnosis of substance-induced psychosis. Being male, DUP and baseline positive symptoms predicted non-remission at one year.

CONCLUSION

Prodromal symptoms were not linked with outcome after a year of treatment which could be explained by greater heterogeneity in illness psychopathology which may be more pronounced in broad FEP diagnoses at different stages. It could also be explained by prodromal symptoms exerting greater influence earlier in the course illness.

Authors+Show Affiliations

School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK. Electronic address: laoiserenwick@gmail.com.DETECT Early Psychosis Service, Dublin, Ireland.DETECT Early Psychosis Service, Dublin, Ireland; Orygen, The National Centre for Excellence in Youth Mental Health, Melbourne, Australia.DETECT Early Psychosis Service, Dublin, Ireland.DETECT Early Psychosis Service, Dublin, Ireland.Cork University Hospital, Cork, Ireland.St. John of God Hospital, Dublin, Ireland; School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland.School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland.

Pub Type(s)

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

Language

eng

PubMed ID

26187148

Citation

Renwick, Laoise, et al. "Prodromal Symptoms and Remission Following First Episode Psychosis." Schizophrenia Research, vol. 168, no. 1-2, 2015, pp. 30-6.
Renwick L, Lyne J, Donoghue BO, et al. Prodromal symptoms and remission following first episode psychosis. Schizophr Res. 2015;168(1-2):30-6.
Renwick, L., Lyne, J., Donoghue, B. O., Owens, L., Doyle, R., Hill, M., McCarthy, E., Pilling, M., O'Callaghan, E., & Clarke, M. (2015). Prodromal symptoms and remission following first episode psychosis. Schizophrenia Research, 168(1-2), 30-6. https://doi.org/10.1016/j.schres.2015.07.001
Renwick L, et al. Prodromal Symptoms and Remission Following First Episode Psychosis. Schizophr Res. 2015;168(1-2):30-6. PubMed PMID: 26187148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prodromal symptoms and remission following first episode psychosis. AU - Renwick,Laoise, AU - Lyne,John, AU - Donoghue,Brian O, AU - Owens,Liz, AU - Doyle,Roisin, AU - Hill,Michele, AU - McCarthy,Emma, AU - Pilling,Mark, AU - O'Callaghan,Eadbhard, AU - Clarke,Mary, Y1 - 2015/07/14/ PY - 2015/02/10/received PY - 2015/06/06/revised PY - 2015/07/01/accepted PY - 2015/7/19/entrez PY - 2015/7/19/pubmed PY - 2016/6/30/medline KW - Duration of prodrome KW - Duration of untreated psychosis KW - First-episode psychosis KW - Prodromal symptoms SP - 30 EP - 6 JF - Schizophrenia research JO - Schizophr Res VL - 168 IS - 1-2 N2 - INTRODUCTION: Describing the trajectory of prodromal symptoms has obvious appeal in supporting advances towards sub-clinical intervention. Identifying clinical phenomena associated with unfavourable illness outcomes could have greater significance in explaining some heterogeneity within and between psychotic disorders and advancing understanding of pre-psychotic typologies. Few studies have assessed the continuity, if any, between prodromal phases and illness outcome one year after treatment. METHODS: We assessed 375 people with first-episode psychosis (FEP) and 215 (57.4%) were seen approximately one year later. We performed factor analysis on prodromal symptom items obtained by interview with families and participants and identified a five-factor solution. We determined whether these factors predicted non-remission from psychosis in the presence of other factors that may predict outcome including premorbid adjustment, duration of prodrome and untreated psychosis (DUP), baseline symptoms and DSM-IV diagnoses. We used random forest classification to predict the most important variables and logistic regression to identify specific predictors. RESULTS: We identified five prodromal symptom factors comprising Negative Symptoms, General Psychopathology, Reality Distortion, Strange Ideas and Irritability. Prodromal symptoms did not predict a greater risk of non-remission with the exception of Irritability and this factor was also associated with earlier age at onset, being male and a diagnosis of substance-induced psychosis. Being male, DUP and baseline positive symptoms predicted non-remission at one year. CONCLUSION: Prodromal symptoms were not linked with outcome after a year of treatment which could be explained by greater heterogeneity in illness psychopathology which may be more pronounced in broad FEP diagnoses at different stages. It could also be explained by prodromal symptoms exerting greater influence earlier in the course illness. SN - 1573-2509 UR - https://www.unboundmedicine.com/medline/citation/26187148/Prodromal_symptoms_and_remission_following_first_episode_psychosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920-9964(15)00340-0 DB - PRIME DP - Unbound Medicine ER -