Predictors of clinical remission following a first episode of non-affective psychosis: Sociodemographics, premorbid and clinical variables

• Published in: Psychiatry research Vol. 206; no. 2; pp. 181 - 187
• Main Authors: Díaz, Ignacio, Pelayo-Terán, Jose María, Pérez-Iglesias, Rocío, Mata, Ignacio, Tabarés-Seisdedos, Rafael, Suárez-Pinilla, Paula, Vázquez-Barquero, José Luis, Crespo-Facorro, Benedicto
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 30.04.2013; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Antipsychotic Agents - therapeutic use; Benzodiazepines - therapeutic use; Biological and medical sciences; Clinical practice; Duration of untreated psychosis (DUP); Educational Status; Female; Haloperidol - therapeutic use; Humans; Logistic Models; Longitudinal Studies; Male; Medical sciences; Negative symptoms; Premorbid adjustment; Prognosis; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - drug therapy; Psychotic Disorders - psychology; Remission Induction; Risk Factors; Risperidone - therapeutic use; Schizophrenia; Schizophrenia - drug therapy; Schizophrenic Psychology; Severity of Illness Index; Time-to-Treatment; Young Adult; Schizophrenia; Negative symptoms; Prognosis; Clinical practice; Premorbid adjustment; Duration of untreated psychosis (DUP); Psychosis; First episode; Sociodemographic factor; Negative symptom; Duration of untreated psychosis; Remission; Predictive factor
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2012.10.011

Abstract The aim of the study was to identify predictors associated with a lower likelihood of achieving a clinical remission 1 year after the first break of the illness. Participants were 174 consecutive subjects included in a first episode programme with no prior treatment with antipsychotic medication. Patients were assigned to haloperidol, olanzapine or risperidone in a randomized, open-label, prospective clinical trial. The main outcome variable was the remission criteria developed by the Remission in Schizophrenia Working Group. Clinical variables were included in a logistic regression analysis in order to predict the remission state at 1 year. At 1 year, 31% of patients met criteria for remission. The logistic regression analysis revealed that the strongest predictors of achieving clinical remission 1 year away from a first episode of non-affective psychosis were the length of duration of untreated psychosis (DUP), the severity of negative symptomatology and the educational level attained at baseline. The results suggest that: (1) patients with a lengthy DUP, a greater severity of negative symptomatology at baseline and with a lower education level are in a higher risk of not achieving a clinical remission during the first year of treatment; and (2) early intervention clinical programs should aim to reduce the length of DUP in order to provide a better outcome for patients.