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Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years

Published online by Cambridge University Press:  19 August 2011

M. Álvarez-Jiménez ,
J. F. Gleeson ,
L. P. Henry ,
S. M. Harrigan ,
M. G. Harris ,
E. Killackey ,
S. Bendall ,
G. P. Amminger ,
A. R. Yung  and
H. Herrman
...Show all authors
M. Álvarez-Jiménez*
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
J. F. Gleeson
Affiliation:
Orygen Youth Health Research Centre, Melbourne, Australia Australian Catholic University, Department of Psychology, Melbourne, Australia
L. P. Henry
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
S. M. Harrigan
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
M. G. Harris
Affiliation:
School of Population Health, The University of Queensland, Brisbane, Australia
E. Killackey
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
S. Bendall
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
G. P. Amminger
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
A. R. Yung
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
H. Herrman
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
H. J. Jackson
Affiliation:
The Department of Psychology, The University of Melbourne, Melbourne, Australia
P. D. McGorry
Affiliation:
Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Orygen Youth Health Research Centre, Melbourne, Australia
*
*Address for correspondence: Dr M. Álvarez-Jiménez, Centre for Youth Mental Health, The University of Melbourne, Australia. (Email: malvarez@unimelb.edu.au)
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Abstract

Background

In recent years there has been increasing interest in functional recovery in the early phase of schizophrenia. Concurrently, new remission criteria have been proposed and several studies have examined their clinical relevance for prediction of functional outcome in first-episode psychosis (FEP). However, the longitudinal interrelationship between full functional recovery (FFR) and symptom remission has not yet been investigated. This study sought to: (1) examine the relationships between FFR and symptom remission in FEP over 7.5 years; (2) test two different models of the interaction between both variables.

Method

Altogether, 209 FEP patients treated at a specialized early psychosis service were assessed at baseline, 8 months, 14 months and 7.5 years to determine their remission of positive and negative symptoms and functional recovery. Multivariate logistic regression and path analysis were employed to test the hypothesized relationships between symptom remission and FFR.

Results

Remission of both positive and negative symptoms at 8-month follow-up predicted functional recovery at 14-month follow-up, but had limited value for the prediction of FFR at 7.5 years. Functional recovery at 14-month follow-up significantly predicted both FFR and remission of negative symptoms at 7.5 years, irrespective of whether remission criteria were simultaneously met. The association remained significant after controlling for baseline prognostic indicators.

Conclusions

These findings provided support for the hypothesis that early functional and vocational recovery plays a pivotal role in preventing the development of chronic negative symptoms and disability. This underlines the need for interventions that specifically address early psychosocial recovery.

Keywords

First-episode psychosisfunctional recoveryremission
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 3 , March 2012 , pp. 595 - 606
Copyright
Copyright © Cambridge University Press 2011

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