Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta‐analysis

AbstractBackgroundReducing hospitalisation and length of stay (LOS) in hospital following first episode psychosis (FEP) is important, yet reliable measures of these outcomes and their moderators are lacking. We conducted a systematic review and meta-analysis to investigate the proportion of FEP cases who were hospitalised after their first contact with services and the LOS in a hospital during follow-up.MethodsStudies were identified from a systematic search across major electronic databases from inception to October 2017. Random effects meta-analyses and meta-regression analyses were conducted.Results81 longitudinal studies encompassing data for 23 280 FEP patients with an average follow-up length of 7 years were included. 55% (95% CI 50.3–60.5%) of FEP cases were hospitalised at least once during follow-up with the pooled average LOS of 116.7 days (95% CI 95.1–138.3). Older age of illness onset and being in a stable relationship were associated with a lower proportion of people who were hospitalised. While the proportion of hospitalised patients has not decreased over time, LOS has, with the sharpest reduction in the latest time period. The proportion of patients hospitalised during follow-up was highest in Australia and New Zealand (78.4%) compared to Europe (58.1%) and North America (48.0%); and lowest in Asia (32.5%). Black ethnicity and longer duration of untreated psychosis were associated with longer LOS; while less severe psychotic symptoms at baseline were associated with shorter LOS.ConclusionOne in two FEP cases required hospitalisation at least once during a 7-year follow-up with an average length of hospitalisation of 4 months during this period. LOS has declined over time, particularly in those countries in which it was previously longest.

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Cannabis use and nonuse in patients with first-episode psychosis: A systematic review and meta-analysis of studies comparing neurocognitive functioning

European Psychiatry ◽

10.1192/j.eurpsy.2019.9 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Teresa Sánchez-Gutiérrez ◽

Belén Fernandez-Castilla ◽

Sara Barbeito ◽

Ana González-Pinto ◽

Juan Antonio Becerra-García ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

First Episode Psychosis ◽

Cannabis Use ◽

Effect Sizes ◽

Neurocognitive Functioning ◽

Psychotic Symptoms ◽

First Episode ◽

Moderator Variables ◽

Episode Psychosis

Abstract Background. The implications of cannabis use in the onset of early psychosis and the severity of psychotic symptoms have resulted in a proliferation of studies on this issue. However, few have examined the effects of cannabis use on the cognitive symptoms of psychosis (i.e., neurocognitive functioning) in patients with first-episode psychosis (FEP). This systematic review and meta-analysis aim to assess the neurocognitive functioning of cannabis users (CU) and nonusers (NU) with FEP. Methods. Of the 110 studies identified through the systematic review of 6 databases, 7 met the inclusion criteria, resulting in 14 independent samples and 78 effect sizes. The total sample included 304 CU with FEP and 369 NU with FEP. The moderator variables were age at first use, duration of use, percentage of males, and age. Results. Effect sizes were not significantly different from zero in any neurocognitive domain when users and NU were compared. Part of the variability in effect sizes was explained by the inclusion of the following moderator variables: (1) frequency of cannabis use (β = 0.013, F = 7.56, p = 0.017); (2) first-generation antipsychotics (β = 0.019, F = 34.46, p ≤ 0.001); and (3) country where the study was carried out (β = 0.266, t = 2.06, p = 0.043). Conclusions. This meta-analysis indicates that cannabis use is not generally associated with neurocognitive functioning in patients with FEP. However, it highlights the deleterious effect of low doses of cannabis in some patients. It also stresses the importance of the type of antipsychotic prescription and cannabis dose as moderator variables in the neurocognitive functioning of CU with FEP.

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The Association Between First-Episode Psychosis and Abnormal Glycaemic Control: Systematic Review and Meta-analysis of Clinical Studies

10.26226/morressier.5885d716d462b8028d891aaa ◽

2017 ◽

Author(s):

Benjamin Perry

Keyword(s):

Systematic Review ◽

Glycaemic Control ◽

Clinical Studies ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

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Outcomes for first-episode psychosis after entry via an at-risk mental state clinic compared to direct entry to a first episode of psychosis service: A systematic review and meta-analysis

Schizophrenia Research ◽

10.1016/j.schres.2021.12.019 ◽

2022 ◽

Vol 240 ◽

pp. 214-219

Author(s):

Holly Sizer ◽

Ellie Brown ◽

Hellen Geros ◽

Alison Yung ◽

Barnaby Nelson ◽

...

Keyword(s):

Systematic Review ◽

At Risk ◽

Mental State ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

At Risk Mental State

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Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies

The British Journal of Psychiatry ◽

10.1192/bjp.bp.117.201475 ◽

2017 ◽

Vol 211 (6) ◽

pp. 350-358 ◽

Cited By ~ 93

Author(s):

John Lally ◽

Olesya Ajnakina ◽

Brendon Stubbs ◽

Michael Cullinane ◽

Kieran C. Murphy ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Prevalence Rates ◽

Recovery Rates ◽

Pooled Prevalence ◽

Episode Psychosis ◽

Remission Rates

BackgroundRemission and recovery rates for people with first-episode psychosis (FEP) remain uncertain.AimsTo assess pooled prevalence rates of remission and recovery in FEP and to investigate potential moderators.MethodWe conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies with more than 1 year of follow-up data, and conducted meta-regression analyses to investigate potential moderators.ResultsSeventy-nine studies were included representing 19072 patients with FEP. The pooled rate of remission among 12301 individuals with FEP was 58% (60 studies, mean follow-up 5.5 years). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 38% (35 studies, mean follow-up 7.2 years). Recovery rates were higher in North America than in other regions.ConclusionsRemission and recovery rates in FEP may be more favourable than previously thought. We observed stability of recovery rates after the first 2 years, suggesting that a progressive deteriorating course of illness is not typical. Although remission rates have improved over time recovery rates have not, raising questions about the effectiveness of services in achieving improved recovery.

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Risk factors for relapse following treatment for first episode psychosis: A systematic review and meta-analysis of longitudinal studies

Schizophrenia Research ◽

10.1016/j.schres.2012.05.007 ◽

2012 ◽

Vol 139 (1-3) ◽

pp. 116-128 ◽

Cited By ~ 192

Author(s):

M. Alvarez-Jimenez ◽

A. Priede ◽

S.E. Hetrick ◽

S. Bendall ◽

E. Killackey ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Longitudinal Studies ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

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Remission and recovery from first-episode psychosis in adults: A systematic review and meta-analysis of long-term outcome studies

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1595 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s819-s819 ◽

Cited By ~ 1

Author(s):

J. Lally ◽

O. Ajnakina ◽

B. Stubbs ◽

M. Cullinane ◽

K.C. Murphy ◽

...

Keyword(s):

Systematic Review ◽

Longitudinal Studies ◽

Meta Analysis ◽

First Episode Psychosis ◽

First Episode ◽

Recovery Rates ◽

Pooled Prevalence ◽

Episode Psychosis ◽

Remission Rates

IntroductionRemission and recovery rates for people who have had a first episode psychosis (FEP) remain uncertain.ObjectivesWe conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies and conducted meta regression analyses to investigate potential moderators.MethodsA systematic literature search of major electronic databases without language restrictions was conducted from database inception until July 1, 2016. Longitudinal studies with follow up greater than 1 year reporting data on remission or recovery rates in FEP were included.ResultsSeventy-nine studies were included representing 19,072 FEP patients (mean age = 26.9 years, male = 59.5%). The pooled rate of remission among 12,301 individuals with FEP was 57.9% (95%CI: 52.7–62.9, Q = 1536.3, P< 0.001, n = 60 studies, mean follow up = 5.5 years). Restricting the analysis to studies, which used the remission in schizophrenia working group (RSWG) criteria (n = 25 studies, n = 6909 patients), the pooled remission rate was 56.9% (95%CI: 48.9–64.5, Q = 656.9). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 37.9% (95%CI: 30.0–46.5, Q = 1450.8, studies = 35, P = 0.006, average follow up = 7.2 years). Recovery rates were higher (P< 0.05) in North America compared to other regions.ConclusionsOur data suggest that remission and recovery rates in FEP may be more favorable than previously thought. We observed stability of recovery rates after the first two years, suggesting that a progressive deteriorating course of illness is not typical. While remission rates have improved over time, recovery rates have not, raising questions about the effectiveness of specialist early intervention services in achieving improved recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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