title: Fear of recurrence: results of a randomized trial of relapse detection in schizophrenia.
abstract: OBJECTIVE
  We aimed to develop and establish the reliability and validity of a measure of Fear of Recurrence, measuring cognitive appraisals of relapse rather than standard early signs of relapse. We also aimed to establish the sensitivity and specificity to relapse.
  
  
  METHODS
  Participants diagnosed with schizophrenia or a related disorder were randomized to one of two early signs monitoring conditions, using either the Early Signs Scale or the Fear of Recurrence Scale (FoRSe). Participants were followed up for 6-months or until relapse.
  
  
  RESULTS
  A total of 169 participants were randomized to Standard (n = 86) or FoRSe (n = 83) monitoring. We found good evidence supporting reliability and validity of the FoRSe. In addition, a cut-off point of ≥ 5 was associated with an optimal sensitivity in both Standard (n = 26:79%, 95% CI = 62-89) and FoRSe (n = 18:72%, 95% CI = 52-86) monitoring. However, this degree of sensitivity was associated with a lower specificity in Standard (n = 30:35%, 96% CI = 23-50) and FoRSe (n = 25:46%, 95% CI = 32-60). Finally, Fear of Relapse was a significant predictor of time to relapse [Exp(β) = 1.20, 95% CI = 1.01-1.42, p < .05].
  
  
  CONCLUSIONS
  The study provides evidence that Fear of Recurrence may be an important clinical construct linked to increased risk of relapse and poorer emotional recovery in people diagnosed with schizophrenia.
  
  
  CONCLUSIONS
  Monitoring Fear of Recurrence is as sensitive to relapse detection as monitoring early signs alone. Greater Fear of Relapse was associated with shorter duration to actual relapse. Fear of recurrence may be an important clinical feature linked to poorer emotional recovery and increased risk of relapse. Fear of Recurrence may be an important focus of psychological therapy to promote emotional recovery and prevention of relapse.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, UK.
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Gumley
authors.forename: Angus
authors.initials: A
authors.lastname: MacBeth
authors.forename: James D
authors.initials: JD
authors.lastname: Reilly
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Grady
authors.forename: Ross G
authors.initials: RG
authors.lastname: White
authors.forename: Hamish
authors.initials: H
authors.lastname: McLeod
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwannauer
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Power
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Fear of Recurrence; Randomized Controlled Trial; Relapse; Schizophrenia