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Symptom remission at 12-weeks strongly predicts long-term recovery from the first episode of psychosis

Research output: Contribution to journalArticle

Paola Dazzan, J.M. Lappin, Margaret Heslin, Kim Donoghue, Ben Lomas, Ulrich Reininghaus, Adanna Onyejiaka, Tim Croudace, Peter Jones, Robin MacGregor Murray, Paul Fearon, Gillian Doody, Craig Morgan

Original languageEnglish
JournalPsychological Medicine
Early online date25 Jul 2019
DOIs
Publication statusE-pub ahead of print - 25 Jul 2019

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Abstract

Background
To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.

Methods
AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.

Results
At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60–7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02–7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23–6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25–8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61–41.42).

Conclusions
Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.

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