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Prolonged recovery in first-episode psychosis

Published online by Cambridge University Press:  06 August 2018

Jane Edwards*
Affiliation:
Centre for Young People's Mental Health, University of Melbourne, Parkville, Australia
Dana Maude
Affiliation:
Centre for Young People's Mental Health, University of Melbourne, Parkville, Australia
Patrick D. McGorry
Affiliation:
Centre for Young People's Mental Health, University of Melbourne, Parkville, Australia
Susan M. Harrigan
Affiliation:
Centre for Young People's Mental Health, University of Melbourne, Parkville, Australia
John T. Cocks
Affiliation:
Centre for Young People's Mental Health, University of Melbourne, Parkville, Australia
*
Correspondence: J. Edwards, Assistant Director (Clinical), EPPIC, Centre for Young People's Mental Health, University of Melbourne, 35 Poplar Road, Parkville, Australia, 3052

Abstract

Background Early identification and specialised treatment of individuals with enduring positive symptoms may assist in alleviating symptoms and has the potential to change the course of illness.

Method Prevalence and descriptive data on enduring positive symptoms in two first-episode samples are outlined. Attempts to incorporate the focus of early intervention for persisting psychosis into routine clinical care of individuals with first-episode psychosis are described.

Results Of the 227 individuals with first-episode psychosis who were assessed using the Brief Psychiatric Rating Scale at 3/6 months and 12 months following initial stabilisation (from a total sample of 347), 6.6% experienced enduring positive symptoms at all three time points. When the analysis was restricted to schizophrenia, schizophreniform and schizoaffective disorders (n=158) the percentage increased to 8.9%. These patients had significantly longer mean duration of untreated psychosis prior to initiation of treatment and, at 12-month follow-up, significantly higher depression and poorer psychosocial functioning.

Conclusions The association of untreated psychosis with treatment resistance supports the argument for early intervention as soon as possible following the onset of psychotic symptoms.

Type
Research Article
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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