Phenomenology and Outcomes of First Episode Psychosis after a Few Years: Insights from Exploring a Hidden Population
Poster A19, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Chen-Chung Liu1; 1National Taiwan University Hospital and College of Medicine
There are contradictory messages regarding the necessity of long-term antipsychotic treatment after first episode psychosis (FEP) and its impact on functioning. A previous study on pre- and early psychotic states (SOPRES) allowed us to trace 81 patients with FEP up to 7-10 years. Among them, 37 patients continuously received services at the study hospital while the others did not have medical records available in recent 5 years. Targeting at these missed 44 patients, we sent 2 mails with careful wording to invite them for interviews to see if they led trajectories different from those who stayed in a university-based hospital system. Totally 21 patients replied, yet only 8 agreed to receive in-depth interviews. Briefly, 2 patients warranted revision of diagnosis as no recurrence of psychotic symptoms in antipsychotic-free for several years but displaying a dysthymic state or demoralized features; 1 has achieved full remission in good functioning, discontinued medications for 1 year, but resumed antipsychotic since feeling impending relapse; 1 fulfilled remission criteria under intermittent low-dose antipsychotics but mainly led a life by keeping a distance from any potential stressor; the other 4 showed common courses of chronic schizophrenia having repeated admission and/or receiving rehabilitation programs at other psychiatric service systems. The trajectories after first episode psychosis should not be over-simplified by a two-by-two table calculating the odds of remission or relapse determined by medication adherence or discontinuation. Examining through a dynamic dimensional perspective, we can gain more insights to decipher the differences in ambiguous information revealed by recent literature.
Topic Area: Diagnosis and Phenomenology