What predicts functional recovery in first-episode psychosis?
Poster A47, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Laoise Renwick1,2, John Lyne2,3,4, Brian O'Donoghue2,5,6, Eric Roche2,8, Caragh Behan2,8, Richard Drake7, Anthony Kinsella2, Eadbhard O'Callaghan2,8, Mary Clarke2,8; 1School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK, 2Dublin and East Treatment and Early Care Team, Blackrock, Dublin, Ireland., 3Royal College of Surgeons, Dublin, Ireland, 4North Dublin Mental Health Service,Dublin, Ireland, 5Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia, 6Centre for Youth Mental Health, University of Melbourne, Australia, 7Institute of Brain Behaviour and Medicine, University of Manchester, Manchester, UK, 8School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
The widening parameters of outcome in first episode psychosis (FEP) call for research relevant to patients and families, namely recovery. Attaining recovery is an ambitious goal and clinical recovery, defined by prognosis in social and functional outcomes, varies considerably. Systematic reviews of epidemiological samples show wide variation in recovery estimates ranging from 40% showing good outcome and 13.5% using more stringent criteria. Few studies combined recovery and symptom remission: they estimated 13-20% met these criteria during follow-up. We estimated this outcome in a large, epidemiological FEP sample obtained between February 2006 and August 2015 (101 months, N = 638). 403 were followed up at one year (SCID-DSM-IV, SANS, SAPS). 350 had information on functional recovery (Strauss-Carpenter Scale). Symptomatic remission using RSWG symptom criteria was attained by 202 (53.3%) participants. Social and occupational recovery was attained by 55.7% (n = 195) and self-care recovery by 82% (n = 287). 126 (36%) met all three functional recovery criteria. There were 107 (30.1%) whose symptoms met remission and recovery criteria simultaneously. Those who achieved functional recovery were younger at onset (Wald = 4.36, p = .036), had better premorbid adjustment (22.18, p <.001) and shorter DUP (8.94, p =.003). Our findings are consistent with studies demonstrating that longer untreated psychosis reduces the prospect of recovery. While the putative effect of reducing DUP would assume an improvement in recovery rates, further research would benefit from understanding the contribution of specific factors during the untreated phase.
Topic Area: Epidemiology