Medication, hospitalizations and mortality in 5 years after first‐episode psychosis in a Swedish nation‐wide cohort

Strålin, Pontus; Hetta, Jerker

doi:10.1111/eip.12697

Cited by 11 publications

(11 citation statements)

References 38 publications

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“…PANSS was used worldwide to estimate psychiatric symptoms for decades. Versions of the five-factor model have been used in diverse SCZ research areas including positive symptom, negative symptom, cognitive defect, hostility/excitement symptom and anxiety/depression symptom ( 26 ).…”

Section: Methodsmentioning

confidence: 99%

“…The existing studies have tried to identified several factors predicting the risk of suicide in individuals with SCZ, which include younger age, male gender, lack of social support, unemployment, being unmarried, being well-educated, being intelligent ( 21 ), a family history of psychiatric disorder, having poor work functioning, higher number of hospitalizations ( 25 ), presence of a previous suicide attempt, poor adherence to treatment, history of suicidal behavior ( 20 ), having had recent (i.e., within past 3 months) life events ( 26 ), having access to lethal means, and seriousness of psychiatric pathology ( 21 ), comorbid affective disorder and the strong stigma of mental illness in rural areas ( 16 ). Furthermore, some studies have also reported that a combination of genetic markers and early traumatic life events might indeed be used to identify patients at risk for suicide attempt in SCZ.…”

Section: Introductionmentioning

confidence: 99%

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Childhood maltreatment increases the suicidal risk in Chinese schizophrenia patients

Cheng

Ju²,

Xia³

et al. 2022

Front. Psychiatry

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ObjectivesChildhood trauma might be a modifiable risk factor among adults with serious mental illness. However, the correlation of child trauma and suicide is unclear, which were cited most frequently as the biggest challenge to schizophrenia (SCZ) patients in China. We aim to study relationships between child trauma and suicide in SCZ patients of different disease stages.MethodsNinety-one participants were included and divided into two groups, namely, first-episode group (n = 46), relapsed group (n = 45). The Positive and Negative Syndrome Scale was used to evaluate the severity of psychotic symptoms. The Beck's Suicide Intent Scale and The Nurses' Global Assessment of Suicide Risk were conducted by patient self-report to assess suicide symptom. The childhood trauma questionnaire was used to estimate severity of traumatic stress experienced during childhood.ResultsChildhood trauma and different dimensions of suicide were significantly higher in the relapsed group than first-episode group (P < 0.01, respectively). BMI has a significant positive relationship with recent psychosocial stress (β = 0.473, t = 3.521, P < 0.001) in first-episode group. As in relapsed group, BMI has a positive effect between severe mental illness and suicide ideation (β = 0.672, t = 5.949, P < 0.001; β = 0.909, t = 2.463, P < 0.001), Furthermore, emotional neglect presented positively related to the suicide risk and proneness to suicidal behavior (β = 0.618, t = 5.518, P < 0.001; β = 0.809, t = 5.356, P < 0.001).ConclusionRelapsed group of patients had significantly more severe childhood trauma, recent psychosocial stress, suicidal risk and proneness to suicidal behavior. BMI and emotional neglect are unique predictors for different dimensions of suicide.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment increases the suicidal risk in Chinese schizophrenia patients

Cheng

Ju²,

Xia³

et al. 2022

Front. Psychiatry

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“…Individuals with pre-onset self-harm had overall higher levels of positive symptoms during follow-up than did individuals without pre-onset self-harm. Most previous research has aggregated self-harm with suicide attempts, and pre-onset with post-onset phases, and found mixed evidence of associations with positive or negative symptoms (Ayesa-Arriola et al, 2015; Challis et al, 2013; Strålin & Hetta, 2019; Togay et al, 2015). To our knowledge, no previous study has specifically examined pre-onset self-harm.…”

Section: Discussionmentioning

confidence: 99%

Transsyndromic trajectories from pre-onset self-harm and subthreshold psychosis to the first episode of psychosis: A longitudinal study.

Paquin

Malla

Iyer

et al. 2023

Journal of Psychopathology and Clinical Science

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Across subthreshold psychotic and nonpsychotic syndromes, symptoms experienced before the onset of a first episode of psychosis (FEP) may index distinct illness trajectories. We aimed to examine the associations between three types of pre-onset symptoms (self-harm, suicide attempts, and subthreshold psychotic) and outcome trajectories during FEP. Participants with FEP were recruited from PEPP-Montreal, a catchment-based early intervention service. Pre-onset symptoms were systematically assessed through interviews with participants (and their relatives) and reviews of health and social records. Over 2 years of follow-up at PEPP-Montreal, 3-8 repeated measures were collected for positive, negative, depressive, and anxiety symptoms, as well as functioning. We applied linear mixed models to examine associations between pre-onset symptoms and outcome trajectories. We found that on average over follow-up, participants with preonset self-harm had more severe positive, depressive, and anxiety symptoms compared with other participants (standardized mean differences: 0.32-0.76), while differences in negative symptoms and functioning were not significant. Associations did not differ by gender and remained similar after adjusting for the duration of untreated psychosis, substance use disorder, or baseline diagnosis of affective psychosis. Over time, depressive and anxiety symptoms improved among individuals with pre-onset self-harm, such that they converged with other individuals by the end of the follow-up. Similarly, pre-onset suicide attempts were associated with elevated depressive symptoms that improved over time. Pre-onset subthreshold psychotic symptoms were not associated with outcomes, except for a slightly different trajectory of functioning. Individuals with pre-onset self-harm or suicide attempts may benefit from early interventions that target their transsyndromic trajectories.

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“…Moreover, a large number of patients demonstrate only partial response to antipsychotic treatment 5 , and a substantial minority of first episode patients demonstrate robust response (defined either as 50% reduction in positive symptoms 4 or as absence of frank psychosis 6,7 ). The first episode of illness is especially important clinically for at least three reasons: 1) it is the phase of illness associated with the greatest risk of suicide 8,9 ; 2) it may be the best opportunity to mitigate long-term illness trajectory 10 ; and 3) the onset period of late adolescence/early adulthood represents a critical period for attaining functional milestones in the transition to independence 11 . Thus, identification of individuals at risk for poor response is an important clinical goal, yet prognostic biomarkers are lacking 12 .…”

Section: Tablementioning

confidence: 99%

Frontal lobe fALFF measured from resting-state fMRI at baseline predicts acute treatment response in first episode psychosis

Lencz

Moyett

Barber

et al. 2021

Preprint

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While antipsychotic medications have been utilized for decades, many patients experiencing psychosis do not demonstrate a satisfactory positive symptom response, even in the first episode of illness. Resting state functional magnetic resonance imaging (rs-fMRI) has increasingly been studied as a potential biomarker of antipsychotic treatment response, but studies to date remain limited in terms of sample size and brain regions examined. The present study examined fractional amplitude of low frequency fluctuations (fALFF) derived from rs-fMRI to search the whole brain, in a hypothesis-free manner, for regions that might predict response to 12 weeks of treatments with standard antipsychotic medications (risperidone or aripiprazole). To our knowledge, the present study represents the largest first episode psychosis treatment sample studied with rs-fMRI to date (N=126). At baseline, patients who would later meet strict criteria for clinical response demonstrated significantly greater baseline fALFF in bilateral orbitofrontal cortex compared to non-responders. In a subset of 62 patients who were scanned a second time at the end of treatment, responders and non-responders demonstrated significant increases in fALFF in differing brain regions. Specifically, responders demonstrated significant increases in fALFF, from baseline to follow-up, in bilateral dorsal prefrontal cortex; prefrontal changes were not observed in non-responders or in healthy individuals (n=45) scanned at two time points. Thus, spontaneous activity in orbitofrontal cortex may serve as a prognostic biomarker of antipsychotic treatment, while spontaneous activity in the dorsal prefrontal cortex may serve as a critical target of effective medication.

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Medication, hospitalizations and mortality in 5 years after first‐episode psychosis in a Swedish nation‐wide cohort

Abstract: The proportion of cases dispensing antipsychotics decreases year by year after first discharge. Mortality and rates of rehospitalization also decrease year by year from high levels the first year.

Cited by 11 publications

References 38 publications

Childhood maltreatment increases the suicidal risk in Chinese schizophrenia patients

Childhood maltreatment increases the suicidal risk in Chinese schizophrenia patients

Transsyndromic trajectories from pre-onset self-harm and subthreshold psychosis to the first episode of psychosis: A longitudinal study.

Frontal lobe fALFF measured from resting-state fMRI at baseline predicts acute treatment response in first episode psychosis

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