Poster #M169 PERSISTANT NEGATIVE SYMPTOMS AFTER FIRST-EPISODE SCHIZOPHRENIA; RESULTS OF 2 YEARS FOLLOW-UP

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.

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

The Canadian Journal of Psychiatry ◽

10.1177/070674370805301005 ◽

2008 ◽

Vol 53 (10) ◽

pp. 660-670 ◽

Cited By ~ 61

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.

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

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.049718 ◽

2008 ◽

Vol 193 (3) ◽

pp. 203-209 ◽

Cited By ~ 85

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.

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Persistent negative symptoms after first episode schizophrenia: A 2-year follow-up study

Schizophrenia Research ◽

10.1016/j.schres.2014.07.021 ◽

2014 ◽

Vol 158 (1-3) ◽

pp. 241-246 ◽

Cited By ~ 26

Author(s):

Alp Üçok ◽

Ceylan Ergül

Keyword(s):

Negative Symptoms ◽

First Episode ◽

Follow Up Study ◽

First Episode Schizophrenia ◽

Persistent Negative Symptoms

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Naturalistic follow-up of co-morbid substance use in schizophrenia: the West London first-episode study

Psychological Medicine ◽

10.1017/s0033291707000797 ◽

2007 ◽

Vol 38 (1) ◽

pp. 79-88 ◽

Cited By ~ 54

Author(s):

I. Harrison ◽

E. M. Joyce ◽

S. H. Mutsatsa ◽

S. B. Hutton ◽

V. Huddy ◽

...

Keyword(s):

Substance Use ◽

Depressive Symptoms ◽

Negative Symptoms ◽

Spatial Working Memory ◽

Problem Drinking ◽

Specific Treatment ◽

First Episode ◽

First Episode Schizophrenia ◽

The Impact

BackgroundThe impact of co-morbid substance use in first-episode schizophrenia has not been fully explored.MethodThis naturalistic follow-up of a cohort of 152 people with first-episode schizophrenia examined substance use and clinical outcome in terms of symptoms and social and neuropsychological function.ResultsData were collected on 85 (56%) of the patient cohort after a median period of 14 months. Over the follow-up period, the proportion of smokers rose from 60% at baseline to 64%. While 30% reported lifetime problem drinking of alcohol at baseline, only 15% had problem drinking at follow-up. Furthermore, while at baseline 63% reported lifetime cannabis use and 32% were currently using the drug, by the follow-up assessment the latter figure had fallen to 18.5%. At follow-up, persistent substance users had significantly more severe positive and depressive symptoms and greater overall severity of illness. A report of no lifetime substance use at baseline was associated with greater improvement in spatial working memory (SWM) at follow-up.ConclusionsPast substance use may impede recovery of SWM performance in people with schizophrenia in the year or so following first presentation to psychiatric services. The prevalence of substance use other than tobacco tends to diminish over this period, in the absence of specific interventions. Persistent substance use in first-episode schizophrenia is associated with more severe positive and depressive symptoms but not negative symptoms, and should be a target for specific treatment intervention.

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