Dissecting the functional outcomes of first episode schizophrenia spectrum disorders: a 10-year follow-up study in the PAFIP cohort

2019 ◽  
pp. 1-14 ◽  
Author(s):  
Rosa Ayesa-Arriola ◽  
Víctor Ortíz-García de la Foz ◽  
Obdulia Martínez-García ◽  
Esther Setién-Suero ◽  
María Luz Ramírez ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Sociodemographic Factors ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Intervention Service ◽  
Treatment Plans ◽  
Cluster Analytic ◽  
First Episode Schizophrenia

Abstract Background The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach. Method A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored. Results The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes. Conclusions The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.

scholarly journals Dissecting the functional outcomes of first episode schizophrenia spectrum disorders: a 10-year follow-up study in the PAFIP cohort – CORRIGENDUM

2020 ◽  
pp. 1-1
Author(s):  
Rosa Ayesa-Arriola ◽  
Víctor Ortíz-García de la Foz ◽  
Obdulia Martínez-García ◽  
Esther Setién-Suero ◽  
María Luz Ramírez ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Follow Up Study ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Deinstitutionalization revisited: a 5-year follow-up of a randomized clinical trial of hospital-based rehabilitation versus specialized assertive intervention (OPUS) versus standard treatment for patients with first-episode schizophrenia spectrum disorders

2010 ◽  
Vol 40 (10) ◽  
pp. 1619-1626 ◽  
Author(s):  
M. Nordentoft ◽  
J. Øhlenschlæger ◽  
A. Thorup ◽  
L. Petersen ◽  
Pia Jeppesen ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Supported Housing ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Episode Psychosis ◽  
Bed Days ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

BackgroundThe effects of hospital-based rehabilitation including weekly supportive psychodynamic therapy compared with specialized assertive intervention and standard treatment has not previously been investigated in first-episode psychosis. The aim of the study was to examine long-term effect on use of institutional care of different intensive interventions for patients with first-episode schizophrenia spectrum disorder on use of psychiatric bed days and days in supported housing.MethodA total of 94 severely ill patients with first-episode schizophrenia spectrum disorders were included in a special part of the Copenhagen OPUS trial and randomized to either the specialized assertive intervention program (OPUS), standard treatment or hospital-based rehabilitation.ResultsIt was a stable pattern that patients randomized to hospital-based rehabilitation spent more days in psychiatric wards and in supported housing throughout the 5-year follow-up period compared with the two other groups. Patients in OPUS treatment spent significantly fewer days in psychiatric wards and supported housing in the first 3 years compared with patients in hospital-based rehabilitation. Due to attrition and small sample size, differences in level of psychotic and negative symptoms at 5-year follow-up could not be evaluated.ConclusionsThe study indicates that hospital-based rehabilitation together with weekly supportive psychodynamic therapy was associated with a continued increased use of psychiatric bed days and days in supported housing. The data cannot justify using hospital-based rehabilitation in first-episode psychosis.

scholarly journals Predictors of Treatment-Resistant and Clozapine-Resistant Schizophrenia: A 12-Year Follow-up Study of First-Episode Schizophrenia-Spectrum Disorders

2020 ◽  
Author(s):  
Sherry Kit Wa Chan ◽  
Hei Yan Veronica Chan ◽  
William G Honer ◽  
Tarun Bastiampillai ◽  
Yi Nam Suen ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Age Of Onset ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Treatment Resistant ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia ◽  
The Impact

Abstract Studies on the long-term development and early predictors of treatment-resistant schizophrenia (TRS) and clozapine-resistant TRS (CR-TRS) in patients with first-episode schizophrenia-spectrum disorders (FES) are limited and have not considered the impact of early intervention services (EIS). This study aimed to explore the development of TRS and CR-TRS among patients with FES over 12 years of follow-up. Of the 1234 patients with FES, 15% developed TRS. A total of 450 patients with schizophrenia or schizoaffective disorder were included in a nested case-control study (157 TRS and 293 non-TRS). Younger age of onset, poorer premorbid social adjustment during adulthood, longer duration of first episode, a greater number of relapses, and a higher antipsychotic dose in the first 24 months were associated with earlier TRS. CR-TRS patients, constituting 25% of TRS patients, had a poorer premorbid social adjustment in late adolescence and longer delay before clozapine initiation compared with non-CR-TRS. CR-TRS had poorer clinical and functional outcomes at 12-year follow-up. However, TRS patients on clozapine had a lower mortality rate compared with non-TRS patients. EIS did not have a significant impact on the development of TRS, but patients in the EIS group had a shorter delay of clozapine initiation. Results suggested that neurodevelopmental factors, early clinical characteristics, and requirement for higher antipsychotic dose may be associated with TRS development, highlighting multiple pathways leading to this form of illness. Specific interventions including relapse prevention and early initiation of clozapine during the early course of illness may reduce the rate of TRS and improve patient outcomes.

scholarly journals S201. HIPPOCAMPAL SUBFIELD VOLUMES AND CHANGE IN BODY MASS OVER 12 MONTHS OF TREATMENT IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Stéfan Du Plessis ◽  
Hilmar Luckhoff ◽  
Sanja Kilian ◽  
Laila Asmal ◽  
Frederika Scheffler ◽  
...  
Keyword(s):  
Substance Use ◽  
Weight Gain ◽  
Body Mass ◽  
Interactive Effect ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Hippocampal Subfields ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Abstract Background In this study, we explored the relationship between hippocampal subfield volumes and change in body mass over 12 months of treatment in 90 first-episode schizophrenia spectrum disorder patients (66 males, 24 females; mean age= 24.7±6.8 years). Methods Body mass index was assessed in patients at baseline, and at months 3, 6, 9 and 12. Hippocampal subfields of interest were assessed using a segmentation algorithm included in the FreeSurfer 6.0 software program. Results Linear regression analysis showed a significant interactive effect between sex and anterior hippocampus size as a predictor of change in body mass over 12 months, adjusting for age, substance use, treatment duration, and posterior hippocampal volumes. In an exploratory sub-analysis, partial correlations revealed a significant association between weight gain and smaller CA1, CA3 and subiculum volumes in females, but not males, adjusting for age and substance use, with similar trends evident for the CA4 and presubiculum subfields. Discussion In conclusion, our findings suggest that smaller anterior hippocampal subfields are associated with the development of weight gain over the course of treatment in first-episode schizophrenia spectrum disorders in a sex-specific fashion, and may partly explain the more severe and ongoing increase in body mass evident for female patients.

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