Predictors of Relapse and Functioning in First-Episode Psychosis: A Two-Year Follow-Up Study

Bergé, Daniel; Mané, Anna; Salgado, P.; Cortizo, Romina; Garnier, C.; Gómez, Lourdes; Diez-Aja, C.; Bulbena, Antoni; Pérez, Ví­ctor

doi:10.1176/appi.ps.201400316

Cited by 75 publications

(46 citation statements)

References 56 publications

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“…In fact, most studies that demonstrated the positive effect of good insight on functional outcomes tended to have longer follow-up periods, for example, at least 12 months, when functioning status would be very much affected by the presence or absence of relapses, which was in turn mediated largely through treatment adherence and good insight. 35,37 On the other hand, our current finding may be related to the nature of the insight instrument SUMD. SUMD consists of three general items, assessing subjects' insight on aspects relating to their understanding of mental illness, psychiatric medications and social consequences of mental illness.…”

Section: Discussionmentioning

confidence: 58%

Predictors of functioning in people suffering from first‐episode psychosis 1 year into entering early intervention service in Hong Kong

Chong

Siu

Kwan

et al. 2016

Early Intervention Psych

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Section: Discussionmentioning

confidence: 58%

Predictors of functioning in people suffering from first‐episode psychosis 1 year into entering early intervention service in Hong Kong

Chong

Siu

Kwan

et al. 2016

Early Intervention Psych

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“…Evidence that insight influences symptoms includes findings that better insight predicts reduced risk of relapse 54 and improvement in positive and negative symptoms 55 . A better insight was also related to improvement in positive, negative and excitement symptoms in two first-episode psychosis samples 55,56 .…”

Section: Insight and Outcomementioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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“…Existing literature provides some information on predictors of treatment outcome in patients with FEP. [12][13][14][15][16][17] Available data, however, are rarely based on epidemiological samples compared with controls, and this increases the risk of underestimating the complexities of treating FEP in real-world services. 18 The present study attempted to deal Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: results from the GET UP pragmatic cluster randomised controlled trial Antonio Lasalvia, Chiara Bonetto, Jacopo Lenzi, Paola Rucci, Laura Iozzino, Massimo Cellini, Carla Comacchio, Doriana Cristofalo, Armando D'Agostino, Giovanni de Girolamo, Katia De Santi, Daniela Ghigi, Emanuela Leuci, Maurizio Miceli, Anna Meneghelli, Francesca Pileggi, Silvio Scarone, Paolo Santonastaso, Stefano Torresani, Sarah Tosato, Angela Veronese, Angelo Fioritti, Mirella Ruggeri and the GET UP Group*…”

mentioning

confidence: 99%

Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: Results from the GET UP pragmatic cluster randomised controlled trial

Lasalvia¹,

Bonetto²,

Lenzi³

et al. 2017

Br J Psychiatry

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The GET UP multi-element psychosocial intervention proved to be superior to treatment as usual in improving outcomes in patients with first-episode psychosis (FEP). However, to guide treatment decisions, information on which patients may benefit more from the intervention is warranted.To identify patients' characteristics associated with (a) a better treatment response regardless of treatment type (non-specific predictors), and (b) a better response to the specific treatment provided (moderators).Some demographic and clinical variables were selected as potential predictors/moderators of outcomes at 9 months. Outcomes were analysed in mixed-effects random regression models. (Trial registration: ClinicalTrials.gov, NCT01436331)Analyses were performed on 444 patients. Education, duration of untreated psychosis, premorbid adjustment and insight predicted outcomes regardless of treatment. Only age at first contact with the services proved to be a moderator of treatment outcome (patients aged ⩾35 years had greater improvement in psychopathology), thus suggesting that the intervention is beneficial to a broad array of patients with FEP.Except for patients aged over 35 years, no specific subgroups benefit more from the multi-element psychosocial intervention, suggesting that this intervention should be recommended to all those with FEP seeking treatment in mental health services.

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Predictors of Relapse and Functioning in First-Episode Psychosis: A Two-Year Follow-Up Study

Abstract: Patients with first-episode psychosis were found to have high relapse rates during the first years after illness onset. Further studies evaluating treatment strategies focused on reducing cannabis use and improving insight in first-episode psychosis should be encouraged.

Cited by 75 publications

References 56 publications

Predictors of functioning in people suffering from first‐episode psychosis 1 year into entering early intervention service in Hong Kong

Predictors of functioning in people suffering from first‐episode psychosis 1 year into entering early intervention service in Hong Kong

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: Results from the GET UP pragmatic cluster randomised controlled trial

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