Prediction of remission and recovery in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study.
OBJECTIVE
The aim of the current study was to investigate the rates and predictors of symptomatic remission and recovery in patients presenting with first-episode psychosis 3 years after treatment initiation.


METHODS
Seven hundred participants aged 15-25 years consecutively enrolled in a territory-wide early intervention programme in Hong Kong from July 2001 to August 2003 fulfilled study inclusion criteria, with 539 completing 3-year follow-up. Baseline and follow-up variables were collected via systematic medical file review. The operational criteria for recovery were based on clinical definition incorporating both symptom and functional dimensions.


RESULTS
By the end of 3-year follow-up, 58.8% (n = 317) and 17.4% (n = 94) of participants met criteria for symptomatic remission and recovery, respectively. Around half (51.2%, n = 276) were not remitted either symptomatically or functionally in the last 12 months of follow-up. Of those who achieved sustained symptomatic remission, only 43.1% were also in functional remission. Patients in symptomatic remission had lower rate of admissions, shorter duration of hospitalisations and more favourable psychosocial functioning than non-remitted counterparts. Logistic regression analysis revealed that female sex, older age of onset of psychosis, shorter duration of untreated psychosis (DUP) and early symptom resolution predicted symptomatic remission at the end of follow-up. Higher educational attainment, superior baseline occupational status and shorter DUP were found to be predictive of recovery.


CONCLUSIONS
In a large representative cohort of Chinese young people presenting with first-episode psychosis, although more than half achieved symptomatic remission 3 years after service entry, the rates of functional remission and recovery were low. More intensive psychosocial interventions may be required to further improve patients' functional outcome.
Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. changwc@hku.hk
Wing Chung
WC
Chang
Jennifer Y
JY
Tang
Christy L
CL
Hui
May M
MM
Lam
Sherry K
SK
Chan
Gloria H
GH
Wong
Cindy P
CP
Chiu
Eric Y
EY
Chen
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis*; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors