Developing a risk-model of time to first-relapse for children and adolescents with a psychotic disorder.
Individuals treated for psychotic disorders and mood disorders with psychotic features have a high likelihood of relapse across the life course. This study examines the relapse rate and its associated predictors for children and adolescents experiencing a first-episode and develops a statistical risk-model for prediction of time to first-relapse. A multiyear, retrospective cohort design was used to track youth, under the age of 18 years, who experienced a first-episode of psychosis, and were admitted to 1 of 6 inpatient hospital psychiatric units (N = 87). Participants were followed for at least 2 years (M = 3.9, SD = 1.3) using survival analysis. Approximately 60% of subjects experienced relapse requiring hospital readmission by the end of follow-up, with 33% readmitted within the first year and 44% within 2 years. Median survival time was 34 months. Cox proportional hazards regression identified 4 key risk factors for relapse: medication nonadherence, female gender, receiving clinical treatment, and a decline in social support before first admission.
Gearing
Robin Edward
RE
Columbia University School of Social Work, New York, New York 10027, USA. rg2372@columbia.edu
Mian
Irfan
I
Sholonsky
Aron
A
Barber
Jim
J
Nicholas
David
D
Lewis
Ralph
R
Solomon
Leigh
L
Williams
Cheryl
C
Lightbody
Shawna
S
Steele
Margaret
M
Davidson
Brenda
B
Manchanda
Rahul
R
Joseph
Llewellyn
L
Handelman
Kenneth
K
Ickowicz
Abel
A
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008960:Models, Psychological; D019964:Mood Disorders / Q000523:psychology*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support