title: Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study.
abstract: BACKGROUND
  Studies of the long-term course and outcome of psychoses tend to focus on cohorts of prevalent cases. Such studies bias samples towards those with poor outcomes, which may distort our understanding of prognosis. Long-term follow-up studies of epidemiologically robust first-episode samples are rare.
  
  
  METHODS
  AESOP-10 is a 10-year follow-up study of 557 individuals with a first episode of psychosis initially identified in two areas in the UK (South East London and Nottingham). Detailed information was collated on course and outcome in three domains (clinical, social and service use) from case records, informants and follow-up interviews.
  
  
  RESULTS
  At follow-up, of 532 incident cases identified, at baseline 37 (7%) had died, 29 (6%) had emigrated and eight (2%) were excluded. Of the remaining 458, 412 (90%) were traced and some information on follow-up was collated for 387 (85%). Most cases (265, 77%) experienced at least one period of sustained remission; at follow-up, 141 (46%) had been symptom free for at least 2 years. A majority (208, 72%) of cases had been employed for less than 25% of the follow-up period. The median number of hospital admissions, including at first presentation, was 2 [interquartile range (IQR) 1-4]; a majority (299, 88%) were admitted a least once and a minority (21, 6%) had 10 or more admissions. Overall, outcomes were worse for those with a non-affective diagnosis, for men and for those from South East London.
  
  
  CONCLUSIONS
  Sustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.
authors: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry,King's College London,UK.
authors: C
authors: C
authors: Morgan
authors: National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London,UK.
authors: J
authors: J
authors: Lappin
authors: Centre for Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry,King's College London,UK.
authors: M
authors: M
authors: Heslin
authors: Addictions Department, Institute of Psychiatry,King's College London,UK.
authors: K
authors: K
authors: Donoghue
authors: Division of Psychiatry,University of Nottingham,UK.
authors: B
authors: B
authors: Lomas
authors: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry,King's College London,UK.
authors: U
authors: U
authors: Reininghaus
authors: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry,King's College London,UK.
authors: A
authors: A
authors: Onyejiaka
authors: Department of Health Sciences,University of York,UK.
authors: T
authors: T
authors: Croudace
authors: Department of Psychiatry,University of Cambridge,UK.
authors: P B
authors: PB
authors: Jones
authors: National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London,UK.
authors: R M
authors: RM
authors: Murray
authors: Department of Psychiatry,Trinity College,Dublin,Ireland.
authors: P
authors: P
authors: Fearon
authors: Division of Psychiatry,University of Nottingham,UK.
authors: G A
authors: GA
authors: Doody
authors: National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London,UK.
authors: P
authors: P
authors: Dazzan
mesh_terms: D000328:Adult; D018450:Disease Progression; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000401:mortality; D012737:Sex Factors