Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis

Ana Catalan; Anja Richter; Gonzalo Salazar De Pablo; Julio Vaquerizo-Serrano; Gonzalo Mancebo; Borja Pedruzo; Claudia Aymerich; Marco Solmi; Miguel A. González-Torres; Patxi Gil; Philip Mcguire; Paolo Fusar-Poli

doi:10.1192/j.eurpsy.2021.2246

Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis

Ana Catalan^*, Anja Richter, Gonzalo Salazar De Pablo, Julio Vaquerizo-Serrano, Gonzalo Mancebo, Borja Pedruzo, Claudia Aymerich, Marco Solmi, Miguel A. González-Torres, Patxi Gil, Philip Mcguire, Paolo Fusar-Poli

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49-58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27-36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.

Original language	English
Article number	e69
Journal	European Psychiatry
Volume	64
Issue number	1
DOIs	https://doi.org/10.1192/j.eurpsy.2021.2246
Publication status	Published - 3 Nov 2021

Keywords

First-episode psychosis
predictors
psychosis
recovery
remission

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1192/j.eurpsy.2021.2246

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Catalan, A., Richter, A., Salazar De Pablo, G., Vaquerizo-Serrano, J., Mancebo, G., Pedruzo, B., Aymerich, C., Solmi, M., González-Torres, M. A., Gil, P., Mcguire, P., & Fusar-Poli, P. (2021). Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis. European Psychiatry, 64(1), Article e69. https://doi.org/10.1192/j.eurpsy.2021.2246

@article{aed1686800964ad69e3dabbb90c35b30,

title = "Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis",

abstract = "Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49-58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27-36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.",

keywords = "First-episode psychosis, predictors, psychosis, recovery, remission",

author = "Ana Catalan and Anja Richter and {Salazar De Pablo}, Gonzalo and Julio Vaquerizo-Serrano and Gonzalo Mancebo and Borja Pedruzo and Claudia Aymerich and Marco Solmi and Gonz{\'a}lez-Torres, {Miguel A.} and Patxi Gil and Philip Mcguire and Paolo Fusar-Poli",

note = "Funding Information: A.C. has received personal fees from Janssen and grants from the Ministry of Health Spanish National Institute of Health Carlos III. M.S. has received honoraria from Angelini, Lundbeck. The remaining authors declare none. Publisher Copyright: {\textcopyright} The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association.",

year = "2021",

month = nov,

day = "3",

doi = "10.1192/j.eurpsy.2021.2246",

language = "English",

volume = "64",

journal = "European Psychiatry",

issn = "0924-9338",

publisher = "Elsevier B.V.",

number = "1",

}

Catalan, A, Richter, A , Salazar De Pablo, G , Vaquerizo-Serrano, J, Mancebo, G, Pedruzo, B, Aymerich, C, Solmi, M, González-Torres, MA, Gil, P, Mcguire, P & Fusar-Poli, P 2021, 'Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis', European Psychiatry, vol. 64, no. 1, e69. https://doi.org/10.1192/j.eurpsy.2021.2246

TY - JOUR

T1 - Proportion and predictors of remission and recovery in first-episode psychosis

T2 - Systematic review and meta-analysis

AU - Catalan, Ana

AU - Richter, Anja

AU - Salazar De Pablo, Gonzalo

AU - Vaquerizo-Serrano, Julio

AU - Mancebo, Gonzalo

AU - Pedruzo, Borja

AU - Aymerich, Claudia

AU - Solmi, Marco

AU - González-Torres, Miguel A.

AU - Gil, Patxi

AU - Mcguire, Philip

AU - Fusar-Poli, Paolo

N1 - Funding Information: A.C. has received personal fees from Janssen and grants from the Ministry of Health Spanish National Institute of Health Carlos III. M.S. has received honoraria from Angelini, Lundbeck. The remaining authors declare none. Publisher Copyright: © The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association.

PY - 2021/11/3

Y1 - 2021/11/3

N2 - Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49-58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27-36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.

AB - Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49-58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27-36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.

KW - First-episode psychosis

KW - predictors

KW - psychosis

KW - recovery

KW - remission

UR - http://www.scopus.com/inward/record.url?scp=85120630142&partnerID=8YFLogxK

U2 - 10.1192/j.eurpsy.2021.2246

DO - 10.1192/j.eurpsy.2021.2246

M3 - Review article

C2 - 34730080

AN - SCOPUS:85120630142

SN - 0924-9338

VL - 64

JO - European Psychiatry

JF - European Psychiatry

IS - 1

M1 - e69

ER -

Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis

Abstract

Keywords

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