title: Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up.
abstract: BACKGROUND
  Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis.
  
  
  METHODS
  The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark.
  
  
  RESULTS
  At all follow-ups, a large proportion (20-30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77-96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56-78%) probability of being in this group at the consecutive follow-up.
  
  
  CONCLUSIONS
  A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: D R
authors.initials: DR
authors.lastname: Gotfredsen
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: R S
authors.initials: RS
authors.lastname: Wils
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Hjorthøj
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: S F
authors.initials: SF
authors.lastname: Austin
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Albert
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: R G
authors.initials: RG
authors.lastname: Secher
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: A A E
authors.initials: AAE
authors.lastname: Thorup
authors.affiliation: The Lundbeck Foundation Initiative for Integrative Psychiatric Research,iPSYCH,Aarhus,Denmark.
authors.forename: O
authors.initials: O
authors.lastname: Mors
authors.affiliation: Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000494:pharmacology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000188:drug therapy*; D012074:Remission Induction; D012075:Remission, Spontaneous; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Schizophrenia; long-term outcome.; medication; psychotic illness