title: Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years.
abstract: BACKGROUND
  In recent years there has been increasing interest in functional recovery in the early phase of schizophrenia. Concurrently, new remission criteria have been proposed and several studies have examined their clinical relevance for prediction of functional outcome in first-episode psychosis (FEP). However, the longitudinal interrelationship between full functional recovery (FFR) and symptom remission has not yet been investigated. This study sought to: (1) examine the relationships between FFR and symptom remission in FEP over 7.5 years; (2) test two different models of the interaction between both variables.
  
  
  METHODS
  Altogether, 209 FEP patients treated at a specialized early psychosis service were assessed at baseline, 8 months, 14 months and 7.5 years to determine their remission of positive and negative symptoms and functional recovery. Multivariate logistic regression and path analysis were employed to test the hypothesized relationships between symptom remission and FFR.
  
  
  RESULTS
  Remission of both positive and negative symptoms at 8-month follow-up predicted functional recovery at 14-month follow-up, but had limited value for the prediction of FFR at 7.5 years. Functional recovery at 14-month follow-up significantly predicted both FFR and remission of negative symptoms at 7.5 years, irrespective of whether remission criteria were simultaneously met. The association remained significant after controlling for baseline prognostic indicators.
  
  
  CONCLUSIONS
  These findings provided support for the hypothesis that early functional and vocational recovery plays a pivotal role in preventing the development of chronic negative symptoms and disability. This underlines the need for interventions that specifically address early psychosocial recovery.
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. malvarez@unimelb.edu.au
authors.forename: M
authors.initials: M
authors.lastname: Álvarez-Jiménez
authors.forename: J F
authors.initials: JF
authors.lastname: Gleeson
authors.forename: L P
authors.initials: LP
authors.lastname: Henry
authors.forename: S M
authors.initials: SM
authors.lastname: Harrigan
authors.forename: M G
authors.initials: MG
authors.lastname: Harris
authors.forename: E
authors.initials: E
authors.lastname: Killackey
authors.forename: S
authors.initials: S
authors.lastname: Bendall
authors.forename: G P
authors.initials: GP
authors.lastname: Amminger
authors.forename: A R
authors.initials: AR
authors.lastname: Yung
authors.forename: H
authors.initials: H
authors.lastname: Herrman
authors.forename: H J
authors.initials: HJ
authors.lastname: Jackson
authors.forename: P D
authors.initials: PD
authors.lastname: McGorry
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003156:Community Mental Health Services; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008962:Models, Theoretical; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012074:Remission Induction; D012559:Schizophrenia / Q000453:epidemiology / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D013997:Time Factors; D055815:Young Adult