Reappraising the Long-term Course and Outcome of Psychotic Disorders: The ÆSOP-10 Study
Craig Morgan,Julia Lappin,Margaret Heslin,Kim Donoghue,Ben Lomas,Ulrich Reininghaus,Adanna Onyejiaka,Tim Croudace,Peter B. Jones,Robin M. Murray,Paul Fearon,Gillian A. Doody,Paola Dazzan +12 more
TLDR
Sustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.Abstract:
Background Studies of the long-term course and outcome of psychoses tend to focus on cohorts of prevalent cases. Such studies bias samples towards those with poor outcomes, which may distort our understanding of prognosis. Long-term follow-up studies of epidemiologically robust first-episode samples are rare. Method AESOP-10 is a 10-year follow-up study of 557 individuals with a first episode of psychosis initially identified in two areas in the UK (South East London and Nottingham). Detailed information was collated on course and outcome in three domains (clinical, social and service use) from case records, informants and follow-up interviews. Results At follow-up, of 532 incident cases identified, at baseline 37 (7%) had died, 29 (6%) had emigrated and eight (2%) were excluded. Of the remaining 458, 412 (90%) were traced and some information on follow-up was collated for 387 (85%). Most cases (265, 77%) experienced at least one period of sustained remission; at follow-up, 141 (46%) had been symptom free for at least 2 years. A majority (208, 72%) of cases had been employed for less than 25% of the follow-up period. The median number of hospital admissions, including at first presentation, was 2 [interquartile range (IQR) 1–4]; a majority (299, 88%) were admitted a least once and a minority (21, 6%) had 10 or more admissions. Overall, outcomes were worse for those with a non-affective diagnosis, for men and for those from South East London. Conclusions Sustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.read more
Citations
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Common schizophrenia alleles are enriched in mutation-intolerant genes and in regions under strong background selection
Antonio F. Pardiñas,Peter Holmans,Andrew Pocklington,Valentina Escott-Price,Stephan Ripke,Stephan Ripke,Noa Carrera,Sophie E. Legge,Sophie Bishop,D. F. Cameron,Marian L. Hamshere,Jun Han,Leon Hubbard,Amy Lynham,Kiran Kumar Mantripragada,Elliott Rees,James H. MacCabe,Steven A. McCarroll,Bernhard T. Baune,Gerome Breen,Gerome Breen,Enda M. Byrne,Udo Dannlowski,Thalia C. Eley,Caroline Hayward,Nicholas G. Martin,Nicholas G. Martin,Andrew M. McIntosh,Robert Plomin,David J. Porteous,Naomi R. Wray,Armando Caballero,Daniel H. Geschwind,Laura M. Huckins,Douglas M. Ruderfer,Enrique Santiago,Pamela Sklar,Eli A. Stahl,Hyejung Won,Esben Agerbo,Esben Agerbo,Thomas Damm Als,Thomas Damm Als,Ole A. Andreassen,Ole A. Andreassen,Marie Bækvad-Hansen,Marie Bækvad-Hansen,Preben Bo Mortensen,Preben Bo Mortensen,Carsten Bøcker Pedersen,Carsten Bøcker Pedersen,Anders D. Børglum,Anders D. Børglum,Jonas Bybjerg-Grauholm,Jonas Bybjerg-Grauholm,Srdjan Djurovic,Srdjan Djurovic,Naser Durmishi,Marianne Giørtz Pedersen,Marianne Giørtz Pedersen,Vera Golimbet,Jakob Grove,David M. Hougaard,David M. Hougaard,Manuel Mattheisen,Manuel Mattheisen,Espen Molden,Ole Mors,Ole Mors,Merete Nordentoft,Merete Nordentoft,Milica Pejovic-Milovancevic,Engilbert Sigurdsson,Teimuraz Silagadze,Christine Søholm Hansen,Christine Søholm Hansen,Kari Stefansson,Hreinn Stefansson,Stacy Steinberg,Sarah Tosato,Thomas Werge,Thomas Werge,Thomas Werge,David A. Collier,David A. Collier,Dan Rujescu,Dan Rujescu,George Kirov,Michael J. Owen,Michael Conlon O'Donovan,James T.R. Walters +90 more
TL;DR: A new genome-wide association study of schizophrenia is reported, and through meta-analysis with existing data and integrating genomic fine-mapping with brain expression and chromosome conformation data, 50 novel associated loci and 145 loci are identified.
Journal ArticleDOI
Improving outcomes of first-episode psychosis: an overview
TL;DR: To improve outcomes of a complex, heterogeneous syndrome such as psychosis, it is necessary to globally adopt complex models integrating a clinical staging framework and coordinated specialty care programmes that offer pre‐emptive interventions to high‐risk groups identified across the early stages of the disorder.
Journal ArticleDOI
Stress Sensitivity, Aberrant Salience, and Threat Anticipation in Early Psychosis: An Experience Sampling Study
Ulrich Reininghaus,Ulrich Reininghaus,Matthew J. Kempton,Lucia Valmaggia,Tom K. J. Craig,Philippa Garety,Adanna Onyejiaka,Charlotte Gayer-Anderson,Suzanne Ho-wai So,Kathryn Hubbard,Stephanie Beards,Paola Dazzan,Carmine M. Pariante,Valeria Mondelli,Helen L. Fisher,John G. Mills,Wolfgang Viechtbauer,Philip McGuire,Jim van Os,Robin M. Murray,Til Wykes,Inez Myin-Germeys,Craig Morgan +22 more
TL;DR: It is suggested that stress sensitivity, aberrant salience, and threat anticipation are important psychological processes in the development of psychotic experiences in daily life in the early stages of the disorder.
Journal ArticleDOI
Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies.
John Lally,Olesya Ajnakina,Brendon Stubbs,Michael Cullinane,Kieran C. Murphy,Fiona Gaughran,Robin M. Murray +6 more
TL;DR: Stability of recovery rates after the first 2 years is observed, suggesting that a progressive deteriorating course of illness is not typical, and remission and recovery rates in FEP may be more favourable than previously thought.
Journal ArticleDOI
Two distinct patterns of treatment resistance: clinical predictors of treatment resistance in first-episode schizophrenia spectrum psychoses
John Lally,Olesya Ajnakina,M. Di Forti,Antonella Trotta,Arsime Demjaha,Anna Kolliakou,Valeria Mondelli,T. Reis Marques,Carmine M. Pariante,Paola Dazzan,S. S. Shergil,Oliver D. Howes,Anthony S. David,James H. MacCabe,Fiona Gaughran,Robin M. Murray +15 more
TL;DR: For the majority of the TR group, antipsychotic TR is present from illness onset, necessitating increased consideration for the earlier use of clozapine.
References
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Journal ArticleDOI
Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus
Nancy C. Andreasen,William T. Carpenter,John M. Kane,Robert A. Lasser,Stephen R. Marder,Daniel R. Weinberger +5 more
TL;DR: The first consensus-based operational criteria for symptomatic remission in schizophrenia are based on distinct thresholds for reaching and maintaining improvement, as opposed to change criteria, allowing for alignment with traditional concepts of remission in both psychiatric and nonpsychiatric illness.
Journal ArticleDOI
A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time?
TL;DR: In light of the potential for second-generation antipsychotic medications to further adversely influence mortality rates in the decades to come, optimizing the general health of people with schizophrenia warrants urgent attention.
Journal ArticleDOI
Recovery from psychotic illness: a 15- and 25-year international follow-up study
Glynn Harrison,Kim Hopper,Tom K. J. Craig,Eugene M. Laska,C Siegel,Joseph Wanderling,K. C. Dube,K. Ganev,R. Giel,W. an der Heiden,S.K. Holmberg,Aleksandar Janca,P.W.H. Lee,C. Leon,S. Malhotra,Anthony J. Marsella,Y. Nakane,Norman Sartorius,Yucun Shen,C. Skoda,R. Thara,S.J. Tsirkin,V. Varma,Dermot Walsh,Durk Wiersma +24 more
TL;DR: A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome, and Sociocultural conditions appear to modify long- term course.
Journal ArticleDOI
One hundred years of schizophrenia: a meta-analysis of the outcome literature.
TL;DR: Overall, less than half of patients diagnosed with schizophrenia have shown substantial clinical improvement after follow-up averaging nearly 6 years, despite considerable gains in improvement rates after mid-century, there has been a decline since the 1970s.
Journal ArticleDOI
The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis
Tom K. J. Craig,Philippa Garety,Paddy Power,Nikola Rahaman,Susannah Colbert,Miriam Fornells-Ambrojo,Graham Dunn +6 more
TL;DR: Limited evidence shows that a team delivering specialised care for patients with early psychosis is superior to standard care for maintaining contact with professionals and for reducing readmissions to hospital.
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