Predictors of clinical remission following a first episode of non-affective psychosis: sociodemographics, premorbid and clinical variables

Psychiatry Res. 2013 Apr 30;206(2-3):181-7. doi: 10.1016/j.psychres.2012.10.011. Epub 2012 Nov 14.

Abstract

The aim of the study was to identify predictors associated with a lower likelihood of achieving a clinical remission 1 year after the first break of the illness. Participants were 174 consecutive subjects included in a first episode programme with no prior treatment with antipsychotic medication. Patients were assigned to haloperidol, olanzapine or risperidone in a randomized, open-label, prospective clinical trial. The main outcome variable was the remission criteria developed by the Remission in Schizophrenia Working Group. Clinical variables were included in a logistic regression analysis in order to predict the remission state at 1 year. At 1 year, 31% of patients met criteria for remission. The logistic regression analysis revealed that the strongest predictors of achieving clinical remission 1 year away from a first episode of non-affective psychosis were the length of duration of untreated psychosis (DUP), the severity of negative symptomatology and the educational level attained at baseline. The results suggest that: (1) patients with a lengthy DUP, a greater severity of negative symptomatology at baseline and with a lower education level are in a higher risk of not achieving a clinical remission during the first year of treatment; and (2) early intervention clinical programs should aim to reduce the length of DUP in order to provide a better outcome for patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Educational Status
  • Female
  • Haloperidol / therapeutic use
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Olanzapine
  • Prognosis
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / psychology
  • Remission Induction
  • Risk Factors
  • Risperidone / therapeutic use
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*
  • Severity of Illness Index
  • Time-to-Treatment
  • Young Adult

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Haloperidol
  • Risperidone
  • Olanzapine