Predictors of functional recovery in first-episode psychosis: A systematic review and meta-analysis of longitudinal studies

Clin Psychol Rev. 2017 Dec:58:59-75. doi: 10.1016/j.cpr.2017.09.007. Epub 2017 Oct 6.

Abstract

Background: Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes.

Aims: To systematically compile and analyse predictors of functional recovery in FEP.

Method: Systematic review and meta-analysis of peer-reviewed, longitudinal studies reporting predictors of functioning, with a minimum 12-month follow-up and at least 80% of participants diagnosed with FEP.

Results: Out of 2205 citations, 274 articles were retrieved for detailed evaluation resulting in 50 eligible studies (N=6669). Sociodemographic, clinical, physical and neuroimaging variables had little impact on long-term functioning. Conversely duration of untreated psychosis (DUP), most cognitive variables, and concurrent remission of positive and negative symptoms were independently related to functional recovery.

Conclusions: These findings strongly support the rationale for early intervention in FEP. Novel treatments targeting cognitive deficits may improve functional outcomes in FEP.

Keywords: First-episode psychosis; Functioning.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Early Medical Intervention / statistics & numerical data*
  • Humans
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Psychotic Disorders / therapy*