Dissecting the functional outcomes of first episode schizophrenia spectrum disorders: a 10-year follow-up study in the PAFIP cohort

Abstract

Background The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach. Method A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored. Results The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes. Conclusions The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.

Understanding sex differences in long-term outcomes after a first episode of psychosis

“…As expected, based on literature and in previous research in our group, females were older at illness onset and admission to the PAFIP program 4,14 . Mean age at onset for females was 4 years higher than that for males.…”

“…The patients constituting the 10-year follow-up PAFIP cohort were reassessed between June 2014 and August 2018. The patients included in the referred period were invited for a reassessment after a time window ranging from 8 to 16 years after initial presentation 4 .…”

“…Its research protocol was approved by the local Research Ethics Committee (CEIm of Cantabria) in accordance with international standards for research ethics (NCT0235832 and NCT02534363). Patients that met criteria for inclusion along with their families provided written informed consent for entry into PAFIP and for PAFIP-10 reassessment 4 .…”

“…However, Seeman et al 3 , reported that women's better outcomes declined over time and approached those of men. Further investigation is thus merited, particularly given the marked heterogeneity previously reported 4 in functional outcomes among first episode of psychosis (FEP) patients, the possible design bias towards samples with poor outcomes 5 , and the lack of long-term studies on sex perspectives.…”

The burden of disease in early schizophrenia – a systematic literature review

“…Schizophrenia is a heterogeneous disease, which varies greatly in its manifestation across patient groups, disease course, and incidence in different parts of the world [1,2]. Globally it was estimated that there were approximately 20 million people with schizophrenia in 2017, amounting to around 12,500 years lived with disability [2].…”