title: Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients.
abstract: We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. Based on Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP and ÆSOP-10), a first episode psychosis cohort was followed-up 10years after first presentation. The Schedules for Clinical Assessment in Neuropsychiatry, WHO Life Chart and Global Assessment of Functioning were used to assess clinical, social and service use outcomes. Seventy-two PMD patients, 218 schizophrenia patients and 70 psychotic bipolar disorder/mania patients were identified at baseline. Differences in outcome between PMD and bipolar patients based on baseline and lifetime diagnosis were minimal. Differences in clinical, social and service use outcomes between PMD and schizophrenia were more substantial with PMD patients showing better outcomes on most variables. However, there was some weak evidence (albeit not quite statistically significant at p<0.05) based on lifetime diagnoses that PMD patients were more likely to attempt suicide (OR 2.31, CI 0.98-5.42, p0.055) and self-harm (OR 2.34, CI 0.97-5.68, p0.060). PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment.
authors.affiliation: King's College London, London, UK. Electronic address: Margaret.Heslin@kcl.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Heslin
authors.affiliation: University of New South Wales, Sydney, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Lappin
authors.affiliation: King's College London, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Donoghue
authors.affiliation: Nottinghamshire Healthcare NHS trust, UK.
authors.forename: B
authors.initials: B
authors.lastname: Lomas
authors.affiliation: King's College London, London, UK; Maastricht University, The Netherlands.
authors.forename: U
authors.initials: U
authors.lastname: Reininghaus
authors.affiliation: King's College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Onyejiaka
authors.affiliation: University of Dundee, Dundee, UK.
authors.forename: T
authors.initials: T
authors.lastname: Croudace
authors.affiliation: University of Cambridge, and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
authors.forename: P B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: King's College London, London, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: Trinity College, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Fearon
authors.affiliation: University of Nottingham, Nottingham, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Doody
authors.affiliation: King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: King's College London, London, UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Craig
authors.affiliation: King's College London, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Morgan
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000628:therapy; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011330:Prisons; D011618:Psychotic Disorders / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D012044:Regression Analysis; D012559:Schizophrenia / Q000453:epidemiology* / Q000628:therapy; D016728:Self-Injurious Behavior / Q000453:epidemiology; D012934:Social Isolation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Depression; Outcomes; Prognosis; Psychosis; Psychotic major depression