One year outcome in first episode psychosis: influence of DUP and other predictors

Malla, Ashok; Norman, Ross; Manchanda, Rahul; Ahmed, M.Rashid; Scholten, Derek; Harricharan, Raj; Cortese, Leonard; Takhar, Jatinder

doi:10.1016/s0920-9964(01)00254-7

Cited by 206 publications

(191 citation statements)

References 21 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…Adequate treatment was defined as taking medication for a period of 1 month or until significant response, whichever came first. 5 The information from CORS was corroborated via additional interviews with family members, treating psychiatrist, and clinical case managers. Final ratings on DUP were arrived through consensus between the interviewer and 2 senior researcher-clinicians.…”

Section: Assessments Independent Variables Demographics and Patient mentioning

confidence: 99%

“…Despite high rates of response to antipsychotic medication in the early phase of psychosis, 4,5 considerable variation in the level of (partial, compared with complete) and time to remission 4,5 are influenced significantly by adherence to medication, 7 in addition to other predictors, such as DUP and premorbid adjustment. 5,[8][9][10] Poor adherence has also been associated with an increased risk and rate of relapse, 11,12 increased number of voluntary and involuntary admissions, 13 greater levels of residual positive symptoms, 12 and poor quality of life, 12 social relations, and activities of daily living.…”

mentioning

confidence: 99%

“…5,[8][9][10] Poor adherence has also been associated with an increased risk and rate of relapse, 11,12 increased number of voluntary and involuntary admissions, 13 greater levels of residual positive symptoms, 12 and poor quality of life, 12 social relations, and activities of daily living. 14 Outcome in the early phase of illness may be associated with longer-term global outcome in schizophrenia.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

et al. 2009

View full text Add to dashboard Cite

Objective: To examine the hypothesis that poorer social and family support, identifiable at the onset of treatment, is associated with nonadherence in the first 6 months of treatment of patients with first-episode psychosis (FEP), independent of other patient-related factors.Method: Consecutive patients (n = 100) admitted to a specialized early intervention service for FEP who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for either a schizophrenia spectrum disorder or an affective psychosis were evaluated monthly for 6 months regarding their adherence to medications. Using sociodemographic and illness-related factors, including social and family support, as independent variables and adherence as the dependent variable, univariate analyses were followed by logistic regression.Results: Fifty-six patients (54.9%) were adherent (76% to 100% of doses taken) and 46 (45.1%) nonadherent (less than 76% of doses taken). Nonadherent patients were less likely to have received a good level of social support (c 2 = 5.89, df = 1, P = 0.02), as rated by their respective case manager, and more likely to be single (Fisher exact test, P = 0.019) and to have refused medication at the first offer of treatment (c 2 = 19.70, df = 1, P = 0.001). Using logistic regression, both the level of social support (OR = 3.552, P = 0.03) and early medication acceptance (OR = 11.092, P < 0.001) were significant as predictors of adherence. Conclusion Clinical Implications· Social and family support may be an important determinant of adherence to medication very early in the course of treatment of FEP. · Refusal to be treated at the first offer of treatment remains the most likely reason for nonadherence to medication, at least in the first 6 months of treatment of FEP. · Interventions may need to be designed to influence adherence to medication very early in the course of treatment. Limitations· The measure of social and family support used may have been too brief and not able to tap into different aspects of support from family and others in the social environment. · The absence of influence of insight on adherence to medication might have resulted from using the one item from the Positive and Negative Symptom Scale for assessing insight and not using a more detailed measure of insight. · The relatively high level of nonadherence may be a reflection of a very conservative measure of adherence to medication (taking greater than 75% of doses of medication prescribed).

show abstract

Section: Assessments Independent Variables Demographics and Patient mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

et al. 2009

View full text Add to dashboard Cite

show abstract

“…This measure does not, of course, take into account the duration of untreated psychosis (DUP) [14,15], which is defined as the time from manifestation of the first psychotic symptoms to initiation of adequate treatment. Adequate treatment is defined as the taking of antipsychotic medication for a period of 1 month or until significant response was achieved or whichever came first [41]. It is worth noting here that DUP measures are notoriously difficult to obtain and standardise and it was simply not possible to include accurate estimates of this measure in our calculations.…”

Section: Introductionmentioning

confidence: 99%

Visual sensory processing deficits in Schizophrenia and their relationship to disease state

Yeap

Kelly

Sehatpour

et al. 2008

Eur Arch Psychiatry Clin Neurosc

View full text Add to dashboard Cite

Context Visual Evoked Potential (VEP) abnormalities have been a fairly consistent finding in patients with schizophrenia, and it has been suggested that electrophysiological markers of early sensory processing may be useful as trait markers for the illness, and for development as potential diagnostic measures. Objective Clear amplitude reductions in the occipital P1 component of the VEP (~100 ms), have been repeatedly demonstrated in patients with schizophrenia. Here, we investigated whether the extent of this deficit was related to age, clinical symptoms, medication status and length of illness, in a large cohort of ethnically homogenous patients. Design, setting and participants VEP responses to simple isolated-check stimuli were examined in 52 DSM-IV diagnosed patients with schizophrenia, and compared with responses from 26 healthy age-matched control subjects. Using high-density electrical scalp recordings, we assessed the integrity of the visual P1 component across the two groups. This study was conducted at St.Vincent's Psychiatric Hospital in Fairview, Dublin, Ireland. Results Substantially reduced P1 amplitude was demonstrated in the patient group compared to controls. The deficit was not linked to age, length of illness or medication status. A small positive correlation, accounting for about 11% of the variance, was found between P1 amplitude and clinical symptoms scales (BPRS and SANS). In addition, we found that a slightly later (~110 ms) fronto-central component was relatively increased in the patient group, and was inversely correlated with the occipital P1 amplitude in the patients, but not in the healthy control subjects.Conclusions Our findings clearly demonstrate a deficit in early visual processing in patients with schizophrenia (with a large effect size; Cohen's d = 0.7) that is unrelated to chronicity. The results are consistent with recent findings showing that the P1 deficit is endophenotypic of the disorder and related to genetic risk factors rather than the disease process itself.j Key words visual-evoked potential AE VEP AE ERP AE P1 deficit AE schizophrenia AE Ireland AE hyperfrontality

show abstract

“…Though these two programmes are not comparable due to their varying activities, it is possible to see that the DUP in the RIPEPP programme is somewhat longer than the DUP1 measured in the TIPP programme in Switzerland. However, several surveys (Malla et al 2002, Sheitman et al 2006) stress that the application of the treatment within the first six months is crucial in predicting the further course of the disease, and the general development of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Early Intervention Programme for Patients With Psychotic Disorders in “Sveti Ivan”. Psychiatric Hospital (Ripepp) - Sociodemographic and Baseline Characteristics of the Participants

et al. 2017

View full text Add to dashboard Cite

SUMMARY Results: Majority of the participants were male (66%), at the average age of 28 (SD=6.6), living with their parents (73.5%). Most of them finished secondary school (45.7%) but almost a quarter of the sample (23.7%) is currently studying at university. The average duration of untreated period was 101.60 days, with a median of 30 days. According to results of HONOS questionnaire, upon entry into the programme, the patients most often listed cognitive functioning (attention, concentration, memory) and professional issues (performance of work tasks and activities tied to work) as the most problematic areas.Conclusion: The findings of this study provide more detailed description of the beneficiaries of the RIPEPP programme, which can contribute to forming future programmes for the prevention of psychotic disorders.

show abstract

One year outcome in first episode psychosis: influence of DUP and other predictors

Cited by 206 publications

References 21 publications

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

Early Predictors of Nonadherence to Antipsychotic Therapy in First-Episode Psychosis

Visual sensory processing deficits in Schizophrenia and their relationship to disease state

Early Intervention Programme for Patients With Psychotic Disorders in “Sveti Ivan”. Psychiatric Hospital (Ripepp) - Sociodemographic and Baseline Characteristics of the Participants

Contact Info

Product

Resources

About