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

Research output: Contribution to journalArticle

John Lally ; Olesya Ajnakina ; Brendon Stubbs ; Michael Cullinane ; Kieran C. Murphy ; Fiona Gaughran ; Robin M. Murray

Original languageEnglish
Pages (from-to)350-358
JournalBritish Journal of Psychiatry
Volume211
Issue number4
Early online date5 Oct 2017
DOIs
StatePublished - Dec 2017

King's Authors

Abstract

Background Remission 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.Method We 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.Results Seventy-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.Conclusions Remission 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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