The McLean-Harvard first-episode project: 6-month symptomatic and functional outcome in affective and nonaffective psychosis.
BACKGROUND
The McLean-Harvard First-Episode Project recruited affective and nonaffective patients at their first lifetime psychiatric hospitalization.


METHODS
Baseline evaluation and 6-month follow-up in 257 cases yielded recovery outcomes defined by syndromal (absence of DSM-IV criteria for a current episode) and functional (vocational and residential status at least at baseline levels) status. Time to recovery was assessed by survival analysis, and risk factors by multivariate logistic regression.


RESULTS
Syndromal recovery was attained by 77% of cases over an average of 84 days. By diagnostic group, syndromal recovery rates ranked (p = .001) major affective disorders (81%) > nonaffective acute psychoses (74%) > schizoaffective disorders (70%) > schizophrenia (36%). Functional recovery was significantly associated to syndromal recovery, diagnosis, shorter hospitalization normalized to year, and older age at onset. Average hospital stay declined across the study period, but recovery did not vary with year of entry.


CONCLUSIONS
Syndromal recovery was achieved by nearly one half of patients within 3 months of a first lifetime hospitalization for a psychotic illness, but functional recovery was not achieved by 6 months in nearly two thirds of patients who had attained syndromal recovery.
Tohen
M
M
International Consortium for Bipolar Disorders Research, Harvard Medical School, Boston, USA.
Strakowski
S M
SM
Zarate
C
C
Hennen
J
J
Stoll
A L
AL
Suppes
T
T
Faedda
G L
GL
Cohen
B M
BM
Gebre-Medhin
P
P
Baldessarini
R J
RJ
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D017668:Age of Onset; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000628:therapy*; D012565:Schizophrenic Psychology; D016019:Survival Analysis; D016896:Treatment Outcome