Prognostic Value of Affective Symptoms in First-Admission Psychotic Patients

Abstract

Background: Very little research has been conducted in patients with first-episode psychosis using a dimensional approach. Affective dimensional representations might be useful to predict the clinical course and treatment needs in such patients. Methods: Weincluded 112 patients with first-episode psychosis in a longitudinal-prospective study with a five-year follow-up (N = 82). Logistic analyses were performed to determine the predictive factors associated with depressive, manic, activation, and dysphoric dimensions. Results: High scores on the depressive dimension were associated with the best prognosis. On the other hand, high scores on the activation dimension and the manic dimension were associated with a poorer prognosis in terms of relapses. Only the dysphoric dimension was not associated with syndromic or functional prognosis. Conclusion: Ourresults suggest that the pattern of baseline affective symptoms helps to predict the course of psychotic illness. Therefore, the systematic assessment of affective symptoms would enable us to draw important conclusions regarding patients’ prognosis. Interventions for patients with high scores on manic or activation dimensions could be beneficial in decreasing relapses in first-episode psychosis.

Depression during first episode psychosis and subsequent suicide risk: A systematic review and meta-analysis of longitudinal studies

“…Four studies used nonstandardized measures: three used informal interviewing with medical records and one used medical records alone. For two studies, the method of assessing suicidal behaviour was unclear (Arrasate, 2016;Koreen et al, 1993). The final study measured suicide attempt and ideation using the suicidal behaviour score of the Calgary Depression Scale for Schizophrenia (CDSS) during the 2 weeks prior to follow-up (Barrett, 2015) and was excluded as part of a sensitivity analysis.…”

Differences in Treatment of Schizoaffective Disorder and Schizophrenia in Real Clinical Practice in Slovakia

“…This could be explained by the predominance of the depressive type of SAD, which often has a chronic course with negative consequences on all aspects of social functioning and on health care utilization [18] [19]. In contrast, association between psychosis and affective symptoms, including manic and depressive symptoms, has been identified as a positive prognostic factor [20]. Moreover, in our study, there were repeated hospitalizations and a longer course of the mental disorder in both groups, in which case even the course of SAD could turn into progressive with residual symptoms.…”

Long‐term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes

“…BD‐I diagnoses were most likely to follow: emotional instability (32.4%), depression (18.1%), suicidal ideation or behavior (12.5%), or substance abuse (11.6%). Previous research emphasized the importance of manic features and behavioral activation at first hospitalization for a psychotic illness in predicting later diagnoses of BD 41,42 . SzAffD subjects had experienced: early depression (31.0%), affective instability (18.3%), substance abuse (15.5%), or dysfunction (9.86%) much more than those with other diagnoses.…”