Early identification of non-remission in first-episode psychosis in a two-year outcome study.
OBJECTIVE
To identify predictors of non-remission in first-episode, non-affective psychosis.


METHODS
During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years.


RESULTS
One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for <6 months (n = 38) and for more than 6 months (n = 207), duration of untreated psychosis (DUP) was the only variable that significantly differentiated the groups (median DUP: 25.5, 14.4 and 6.0 weeks, respectively). Three months univariate predictors of non-remission were being single, longer DUP, core schizophrenia, and less excitative and more negative symptoms at baseline. Two-year predictors were younger age, being single and male, deteriorating premorbid social functioning, longer DUP and core schizophrenia. In multivariate analyses DUP, negative and excitative symptoms predicted non-remission at 3 months, but only DUP predicted at 2 years.


CONCLUSIONS
Long DUP predicted both 3 month and 2-year non-remission rates in first-episode psychosis.
Simonsen
Erik
E
Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde University and University of Copenhagen, Copenhagen, Denmark. es@regionsjaelland.dk
Friis
S
S
Opjordsmoen
S
S
Mortensen
E L
EL
Haahr
U
U
Melle
I
I
Joa
I
I
Johannessen
J O
JO
Larsen
T K
TK
Røssberg
J I
JI
Rund
B R
BR
Vaglum
P
P
McGlashan
T H
TH
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D012074:Remission Induction; D012737:Sex Factors; D012917:Social Adjustment; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000523:psychology; D016896:Treatment Outcome; D055815:Young Adult