Neuropsychological (NP) follow-up of first episode schizophrenia

1991 ◽  
Vol 29 (9) ◽  
pp. 106
Keyword(s):  
First Episode ◽  
First Episode Schizophrenia

Predictors of outcome in first-episode schizophrenia over the first 4 years of illness

2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Global Assessment Of Functioning ◽  
Methodological Issues ◽  
Course Of Illness ◽  
Dsm Iv ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.

scholarly journals A longitudinal study of gene expression in first-episode schizophrenia; exploring relapse mechanisms by co-expression analysis in peripheral blood

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
P. Gassó ◽  
N. Rodríguez ◽  
A. Martínez-Pinteño ◽  
G. Mezquida ◽  
M. Ribeiro ◽  
...  
Keyword(s):  
Gene Expression ◽  
Expression Analysis ◽  
Peripheral Blood ◽  
Protein Modification ◽  
First Episode ◽  
Risk Genes ◽  
Relapse Prediction ◽  
First Episode Schizophrenia ◽  
Potential Biomarkers

AbstractLittle is known about the pathophysiological mechanisms of relapse in first-episode schizophrenia, which limits the study of potential biomarkers. To explore relapse mechanisms and identify potential biomarkers for relapse prediction, we analyzed gene expression in peripheral blood in a cohort of first-episode schizophrenia patients with less than 5 years of evolution who had been evaluated over a 3-year follow-up period. A total of 91 participants of the 2EPs project formed the sample for baseline gene expression analysis. Of these, 67 provided biological samples at follow-up (36 after 3 years and 31 at relapse). Gene expression was assessed using the Clariom S Human Array. Weighted gene co-expression network analysis was applied to identify modules of co-expressed genes and to analyze their preservation after 3 years of follow-up or at relapse. Among the 25 modules identified, one module was semi-conserved at relapse (DarkTurquoise) and was enriched with risk genes for schizophrenia, showing a dysregulation of the TCF4 gene network in the module. Two modules were semi-conserved both at relapse and after 3 years of follow-up (DarkRed and DarkGrey) and were found to be biologically associated with protein modification and protein location processes. Higher expression of DarkRed genes was associated with higher risk of suffering a relapse and early appearance of relapse (p = 0.045). Our findings suggest that a dysregulation of the TCF4 network could be an important step in the biological process that leads to relapse and suggest that genes related to the ubiquitin proteosome system could be potential biomarkers of relapse.

The Scottish First Episode Schizophrenia Study

1992 ◽  
Vol 161 (4) ◽  
pp. 496-500 ◽  
Author(s):  
Robin G. McCreadie ◽  
David H. Wiles ◽  
Martin G. Livingston ◽  
James A. G. Watt ◽  
J. G. Greene ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Drug Therapy ◽  
Psychological Stress ◽  
Antipsychotic Drug ◽  
First Episode ◽  
Poor Outcome ◽  
Schizophrenic Patients ◽  
First Episode Schizophrenia ◽  
First Admission

Forty-four schizophrenic patients were followed up for five years after their first admission to hospital for a first episode of illness. Thirteen (30%) of 43 patients had not relapsed; 28 of the 30 patients who did relapse did so within the first 42 months. The relapses occurred despite antipsychotic drug therapy. Also, 24% of patients had at least one course of ECT. Only 19% of the patients at five years were in open employment; unemployment was strongly associated with relapse. Eighteen per cent had neither relapses nor schizophrenic symptoms at follow-up. Poor outcome at five years was associated with greater psychological distress among relatives at first admission. At five years 43% of relatives continued to show case level psychological stress.

scholarly journals Predictors of Remission and Recovery in a First-Episode Schizophrenia Spectrum Disorder Sample: 2-Year Follow-up of the OPUS Trial

2008 ◽  
Vol 53 (10) ◽  
pp. 660-670 ◽  
Author(s):  
Lone Petersen ◽  
Anne Thorup ◽  
Johan Øqhlenschlæger ◽  
Torben Øqstergaard Christensen ◽  
Pia Jeppesen ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Negative Symptoms ◽  
Spectrum Disorder ◽  
First Episode ◽  
Schizophrenia Spectrum Disorder ◽  
Adherence To Medication ◽  
Premorbid Adjustment ◽  
Schizophrenia Spectrum ◽  
First Episode Schizophrenia

Objective: To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD). Method: We conducted a 2-year follow-up of a cohort of patients ( n = 547) with first-episode SSD. We evaluated the patients on demographic variables, diagnosis, duration of untreated psychosis (DUP), premorbid functioning, psychotic and negative symptoms, substance abuse, adherence to medication, and service use. ORs were calculated with logistic regression analyses. Results: A total of 369 patients (67%) participated in the follow-up interview. After 2 years, 36% remitted and 17% were considered fully recovered. Full recovery was associated with shorter DUP, better premorbid adjustment, fewer negative symptoms at baseline, no substance abuse at baseline, and adherence to medication and OPUS treatment. Conclusions: Several predictive factors were identified, and focus should be on potentially malleable predictors of outcome, for example, reducing DUP and paying special attention to patients who are unlikely to achieve good outcome, for example, patients with a substance abuse problem and poor premorbid adjustment.

scholarly journals Duration of untreated psychosis and social function: 1-year follow-up study of first-episode schizophrenia

2008 ◽  
Vol 193 (3) ◽  
pp. 203-209 ◽  
Author(s):  
Thomas R. E. Barnes ◽  
Verity C. Leeson ◽  
Stanley H. Mutsatsa ◽  
Hilary C. Watt ◽  
Sam B. Hutton ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Social Function ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Clinical Difference ◽  
Path Analyses ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundIn first-episode schizophrenia, longer duration of untreated psychosis (DUP) predicts poorer outcomes.AimsTo address whether the relationship between DUP and outcome is a direct causal one or the result of association between symptoms and/or cognitive functioning and social functioning at the same time point.MethodSymptoms, social function and cognitive function were assessed in 98 patients with first-episode schizphrenia at presentation and 1 year later.ResultsThere was no significant clinical difference between participants with short and long DUP at presentation. Linear regression analyses revealed that longer DUP significantly predicted more severe positive and negative symptoms and poorer social function at 1 year, independent of scores at presentation. Path analyses revealed independent direct relationships between DUP and social function, core negative symptoms and positive symptoms. There was no significant association between DUP and cognition.ConclusionsLonger DUP predicts poor social function independently of symptoms. The findings underline the importance of taking account of the phenomenological overlap between measures of negative symptoms and social function when investigating the effects of DUP.

scholarly journals Unmet needs in patients with first-episode schizophrenia: a longitudinal perspective

2011 ◽  
Vol 42 (7) ◽  
pp. 1461-1473 ◽  
Author(s):  
K. Landolt ◽  
W. Rössler ◽  
T. Burns ◽  
V. Ajdacic-Gross ◽  
S. Galderisi ◽  
...  
Keyword(s):  
Latent Class ◽  
Unmet Needs ◽  
Multinomial Logistic Regression ◽  
Psychosocial Treatment ◽  
First Episode ◽  
Patient Groups ◽  
First Episode Schizophrenia ◽  
Latent Class Growth

BackgroundThis study aimed to identify the course of unmet needs by patients with a first episode of schizophrenia and to determine associated variables.MethodWe investigated baseline assessments in the European First Episode Schizophrenia Trial (EUFEST) and also follow-up interviews at 6 and 12 months. Latent class growth analysis was used to identify patient groups based on individual differences in the development of unmet needs. Multinomial logistic regression determined the predictors of group membership.ResultsFour classes were identified. Three differed in their baseline levels of unmet needs whereas the fourth had a marked decrease in such needs. Main predictors of class membership were prognosis and depression at baseline, and the quality of life and psychosocial intervention at follow-up. Depression at follow-up did not vary among classes.ConclusionsWe identified subtypes of patients with different courses of unmet needs. Prognosis of clinical improvement was a better predictor for the decline in unmet needs than was psychopathology. Needs concerning social relationships were particularly persistent in patients who remained high in their unmet needs and who lacked additional psychosocial treatment.

Poster #43 STRUCTURAL BRAIN CHANGES IN FIRST-EPISODE SCHIZOPHRENIA: A 4-5 YEAR FOLLOW-UP STUDY USING MRI

2012 ◽  
Vol 136 ◽  
pp. S201
Author(s):  
Maristela S. Schaufelberger ◽  
Pedro G. Rosa ◽  
Marcus V. Zanetti ◽  
Fabio L. Duran ◽  
Paulo R. Menezes ◽  
...  
Keyword(s):  
First Episode ◽  
Follow Up Study ◽  
Brain Changes ◽  
First Episode Schizophrenia ◽  
Structural Brain

scholarly journals Metabolic risk factors in first-episode schizophrenia: baseline prevalence and course analysed from the European First-Episode Schizophrenia Trial

2013 ◽  
Vol 16 (5) ◽  
pp. 987-995 ◽  
Author(s):  
W. Wolfgang Fleischhacker ◽  
Cynthia O. Siu ◽  
Robert Bodén ◽  
Elizabeth Pappadopulos ◽  
Onur N. Karayal ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Prevalence Rate ◽  
Individual Risk ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Treatment Groups ◽  
Individual Risk Factors ◽  
First Episode Schizophrenia

Abstract Available data on antipsychotic-induced metabolic risks are often constrained by potential confounding effects due to prior antipsychotic treatment. In this study, we assessed the baseline prevalence of metabolic abnormalities and changes following treatment with five commonly-used antipsychotic drugs (haloperidol, amisulpride, olanzapine, quetiapine or ziprasidone) in first-episode, partially antipsychotic-naive patients with schizophrenia in the European first-episode schizophrenia trial (EUFEST). Overall baseline prevalence of metabolic syndrome (MetS) was 6.0%, with similar rates observed in the antipsychotic-naive patients (5.7%, 9/157) and in the other patients with only a brief prior exposure to antipsychotics (6.1%, 20/326). These results are consistent with the MetS prevalence rate estimated in a general population of similar age. Examination of individual risk factors showed 58.5% of subjects had one or more elevated metabolic risks at baseline: 28.5% demonstrated suboptimal HDL; 24.2% hypertension; 17.7% hypertriglyceridemia; 8.2% abdominal obesity; 7.3% hyperglycaemia. Increase in body weight (kg/month) occurred in patients treated with haloperidol (0.62 s.e. 0.11), amisulpride (0.76 s.e. 0.08), olanzapine (0.98 s.e. 0.07) and quetiapine (0.58 s.e. 0.09), which was significantly greater than that in the ziprasidone group (0.18 s.e. 0.10). The incidence rate of new diabetes cases over a 52-wk follow-up period was 0.82% (4/488). More patients experienced worsening rather than improvement of hypertriglyceridemia or hyperglycaemia in all treatment groups. Our findings suggest that in first-episode, partially antipsychotic-naive patients, the baseline prevalence rate of MetS appears to be no higher than that in the general population, but serious underlying individual risk factors nevertheless existed.

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