Tags

Type your tag names separated by a space and hit enter

Duration of active psychosis and functional outcomes in first-episode non-affective psychosis.
Eur Psychiatry. 2018 08; 52:29-37.EP

Abstract

BACKGROUND

The duration of untreated psychosis (DUP) has been associated with negative outcomes in psychosis; however, few studies have focused on the duration of active psychotic symptoms after commencing treatment (DAT). In this study, we aimed to evaluate the effect of DUP and DAT on functional long-term outcomes (3 years) in patients with early psychosis.

METHODS

We evaluated the Scale for the Assessment of Positive Symptoms (SAPS) at frequent intervals for 3 years after presentation to determine the DAT for 307 individuals with first-episode psychosis together with DUP and clinical variables. The functional outcomes were assessed using the Disability Assessment Scale (DAS) at three years, and functional recovery was defined as minimal impairment and return to activity. Associated variables, DAT and DUP were included in logistic regression models to predict functional outcomes. Receiver operating characteristic curves and Youden's index were applied to assess the best cut-off values.

RESULTS

DAT, (Wald: 13.974; ExpB: 1.097; p < 0.001), premorbid adjustment, initial BPRS score, gender, age of onset and schizophrenia diagnosis were significant predictors of social functioning, whereas only premorbid adjustment (Wald: 11.383; ExpB:1.009), DAT (Wald: 4.850; ExpB: 1.058; p = 0.028) and education were significant predictors of recovery. The optimal cut-off of DAT for predicting social functioning was 3.17 months for DAT (sensitivity: 0.68; specificity: 0.64; Youden's index: 0.314).

CONCLUSIONS

DAT is strongly related to functional outcomes independent of the DUP period or other variables. As a modifiable variable, the reduction of the DAT should be considered a main focus of intervention from the onset of the illness to improve long-term outcomes.

Authors+Show Affiliations

University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Unidad de Gestión Clínica de Psiquiatría y Salud Mental, Hospital El Bierzo, Servicio de Salud de Castilla y León (SACYL), Ponferrada, León, Spain. Electronic address: pelayoteran@gmail.com.University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital de Merida, Servicio Estremeño de Salud (SES), Mérida, Badajoz, Spain.University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Psychiatry, University of Valencia, CIBERSAM, Valencia, Spain.University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29614389

Citation

Pelayo-Terán, José María, et al. "Duration of Active Psychosis and Functional Outcomes in First-episode Non-affective Psychosis." European Psychiatry : the Journal of the Association of European Psychiatrists, vol. 52, 2018, pp. 29-37.
Pelayo-Terán JM, Gajardo-Galán V, Gómez-Revuelta M, et al. Duration of active psychosis and functional outcomes in first-episode non-affective psychosis. Eur Psychiatry. 2018;52:29-37.
Pelayo-Terán, J. M., Gajardo-Galán, V., Gómez-Revuelta, M., Ortiz-García de la Foz, V., Ayesa-Arriola, R., Tabarés-Seisdedos, R., & Crespo-Facorro, B. (2018). Duration of active psychosis and functional outcomes in first-episode non-affective psychosis. European Psychiatry : the Journal of the Association of European Psychiatrists, 52, 29-37. https://doi.org/10.1016/j.eurpsy.2018.03.003
Pelayo-Terán JM, et al. Duration of Active Psychosis and Functional Outcomes in First-episode Non-affective Psychosis. Eur Psychiatry. 2018;52:29-37. PubMed PMID: 29614389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Duration of active psychosis and functional outcomes in first-episode non-affective psychosis. AU - Pelayo-Terán,José María, AU - Gajardo-Galán,Virginia, AU - Gómez-Revuelta,Marcos, AU - Ortiz-García de la Foz,Victor, AU - Ayesa-Arriola,Rosa, AU - Tabarés-Seisdedos,Rafael, AU - Crespo-Facorro,Benedicto, Y1 - 2018/03/31/ PY - 2017/12/03/received PY - 2018/03/06/revised PY - 2018/03/08/accepted PY - 2018/4/4/pubmed PY - 2019/3/21/medline PY - 2018/4/4/entrez KW - Early intervention KW - Neurotoxicity hypothesis KW - Positive symptoms KW - Prognosis KW - Prospective study KW - Schizophrenia SP - 29 EP - 37 JF - European psychiatry : the journal of the Association of European Psychiatrists JO - Eur Psychiatry VL - 52 N2 - BACKGROUND: The duration of untreated psychosis (DUP) has been associated with negative outcomes in psychosis; however, few studies have focused on the duration of active psychotic symptoms after commencing treatment (DAT). In this study, we aimed to evaluate the effect of DUP and DAT on functional long-term outcomes (3 years) in patients with early psychosis. METHODS: We evaluated the Scale for the Assessment of Positive Symptoms (SAPS) at frequent intervals for 3 years after presentation to determine the DAT for 307 individuals with first-episode psychosis together with DUP and clinical variables. The functional outcomes were assessed using the Disability Assessment Scale (DAS) at three years, and functional recovery was defined as minimal impairment and return to activity. Associated variables, DAT and DUP were included in logistic regression models to predict functional outcomes. Receiver operating characteristic curves and Youden's index were applied to assess the best cut-off values. RESULTS: DAT, (Wald: 13.974; ExpB: 1.097; p < 0.001), premorbid adjustment, initial BPRS score, gender, age of onset and schizophrenia diagnosis were significant predictors of social functioning, whereas only premorbid adjustment (Wald: 11.383; ExpB:1.009), DAT (Wald: 4.850; ExpB: 1.058; p = 0.028) and education were significant predictors of recovery. The optimal cut-off of DAT for predicting social functioning was 3.17 months for DAT (sensitivity: 0.68; specificity: 0.64; Youden's index: 0.314). CONCLUSIONS: DAT is strongly related to functional outcomes independent of the DUP period or other variables. As a modifiable variable, the reduction of the DAT should be considered a main focus of intervention from the onset of the illness to improve long-term outcomes. SN - 1778-3585 UR - https://www.unboundmedicine.com/medline/citation/29614389/Duration_of_active_psychosis_and_functional_outcomes_in_first_episode_non_affective_psychosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-9338(18)30072-5 DB - PRIME DP - Unbound Medicine ER -