20-Year trajectories of six psychopathological dimensions in patients with first-episode psychosis: Could they be predicted?

• Published in: Psychiatry research Vol. 331; p. 115614
• Main Authors: Cuesta, Manuel J., Gil-Berrozpe, Gustavo J., Sánchez-Torres, Ana M., Moreno-Izco, Lucía, García de Jalón, Elena, Peralta, Victor
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.01.2024
• Subjects: First-episode psychosis; Humans; Latent analysis; Long-term trajectories; Mental Disorders; Predictors; Psychopathological dimensions; Psychopathology; Psychotic Disorders - psychology; First-episode psychosis; Psychopathological dimensions; Latent analysis; Long-term trajectories; Predictors
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2023.115614

•The six dimensions of psychopathology of FEP patients showed great heterogeneity in their long-term trajectories.•The assessments of predictors from the onset of illness may allow targeting a subgroup of FEP patients at high-risk of poor long-term outcome.•A multidimensional assessment at baseline and the follow-up is recommend to better tailoring interventions for the prevention of poor outcomes on specific psychopathological dimensions. Patients with first-episode psychoses (FEP) exhibit heterogeneity in clinical manifestations and outcomes. This study investigated the long-term trajectories of six key psychopathological dimensions (reality-distortion, negative, disorganization, catatonia, mania and depression) in patients diagnosed with FEP. A total of 243 patients were followed up for 20 years and the trajectories of the dimensions were analysed using growth mixture modelling. These dimensions showed varied course patterns, ranging from two to five trajectories. Additionally, the study examined the predictive value of different factors in differentiating between the long-term trajectories. The exposome risk score showed that familial load, distal and intermediate risk factors, acute psychosocial stressors and acute onset were significant predictors for differentiating between long-term psychopathological trajectories. In contrast, polygenic risk score, duration of untreated psychosis and duration of untreated illness demonstrated little or no predictive value. The findings highlight the importance of conducting a multidimensional assessment not only at FEP but also during follow-up to customize the effectiveness of interventions. Furthermore, the results emphasize the relevance of assessing premorbid predictors from the onset of illness. This may enable the identification of FEP patients at high-risk of poor long-term outcomes who would benefit from targeted prevention programs on specific psychopathological dimensions.