Predictors of rate and time to remission in first-episode psychosis: a two-year outcome study.
BACKGROUND
The evidence regarding the independent influence of duration of untreated psychosis (DUP) on rate and time to remission is far from unequivocal. The goal of the current study was to examine the role of predictors for rate and time to remission in first-episode psychosis (FEP).


METHODS
The differential effect of age, gender, age of onset, duration of untreated psychosis (DUP), duration of untreated illness (DUI), pre-morbid adjustment, co-morbid diagnosis of substance abuse and adherence to medication on the rate of and time to remission were estimated using a logistic and Poisson regression, and survival analysis respectively, in FEP patients.


RESULTS
In a sample of 107 FEP patients 82.2% achieved remission over a period of 2 years after a mean of 10.3 weeks (range 1-72). Regression analysis, based on complete data on all variables of interest (n=80), showed status of remission to be positively influenced by better pre-morbid adjustment (RR 0.57, 95% CI 0.34-0.95, p<0.05), later age of onset (RR 1.09, 95% CI 1.05-1.13, p<0.0001), higher level of adherence to medication (RR 1.96, 95% CI 1.38-2.76, p<0.001) and shorter DUI (RR 0.99, 95% CI 0.997-0.999, p<0.005). Time to remission was influenced by age of onset (HR 1.04, 95% CI 1.00-1.08, p<0.04) and adherence to medication (HR 1.58, 95% CI 1.11-2.23, p<0.01).


CONCLUSIONS
Improving adherence to medication early in the course of treatment may be an important intervention to improve short-term outcome.
Malla
Ashok
A
Department of Psychiatry, McGill University, Douglas Hospital Research Centre, Montreal, Quebec, Canada. ashok.malla@douglas.mcgill.ca
Norman
Ross
R
Schmitz
Norbert
N
Manchanda
Rahul
R
Béchard-Evans
Laura
L
Takhar
Jatinder
J
Haricharan
Raj
R
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000627:therapeutic use; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000628:therapy*; D012044:Regression Analysis; D012074:Remission Induction; D012559:Schizophrenia / Q000628:therapy*; D019966:Substance-Related Disorders / Q000523:psychology; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents