Recovery From First-Episode Psychosis More Likely in Those With Mania, Brief Psychosis Diagnoses

According to findings published in Schizophrenia Research, early sustained recovery from first-episode psychosis occurs in a minority of patients, with a baseline diagnosis of mania or brief psychosis strongly predictive of early sustained recovery.  

Investigators conducted a 10-year follow-up study of individuals with first-episode psychosis. Of 345 people studied, 43 (12.5%) achieved early sustained recovery. Individuals who achieved early sustained recovery were predominantly women (65.1%), were employed (62.8%), and were more likely than other individuals to be in a relationship (odds ratio [OR], 2.68; 95% CI, 1.35-5.32). 

Shorter duration of undiagnosed psychosis was also more common in patients with early sustained recovery (OR, 2.86; 95% CI, 1.37-5.88). Additionally, the early sustained recovery group was more likely to have a diagnosis other than schizophrenia, particularly mania (OR, 2.39; 95% CI, 1.22-4.69) or brief psychosis (OR, 3.64; 95% CI, 1.10-12.10). During first-episode psychosis, individuals with early sustained recovery had fewer negative symptoms (OR, 0.72; 95% CI, 0.54-0.98) and fewer symptoms of reality distortion (OR, 0.88; 95% CI, 0.54-0.98). Resultant treatment patterns were demonstrably different between groups (P =.001): 95% of individuals with early sustained recovery began antipsychotic treatment at baseline, but only 15% remained on antipsychotic medications 12 months post-episode. 

A logistic regression model indicated that a diagnosis of mania (P <.001) or brief psychoses (P =.03) was a significant predictor of early sustained recovery.

These findings emphasize the importance of long-term follow-up and care of individuals with first-episode psychosis, with careful consideration given to the risks and benefits of treatment. Predictive factors for early sustained recovery may be useful in developing treatment strategies for patients experiencing first-episode psychosis, although investigators emphasized that early sustained recovery occurs in a minority of patients.

Reference

Lappin JM, Heslin M, Lomas B, et al. Early sustained recovery following first episode psychosis: Evidence from the AESOP10 follow-up study [published online March 20, 2018]. Schizophren Res. doi:10.1016/j.schres.2018.03.014