Clinical and social predictors of psychosis recovery elucidated
MedWire News: A stable family background, good social functioning, and low levels of negative symptoms are significant predictors of recovery in patients with non-affective psychosis, results from a Scandinavian study show.
"Recovery in schizophrenia and schizophrenia-like psychosis has increasingly come into focus… [and] studies on outcome suggest that one-third to one-quarter of patients have the potential of reaching remission," explain Mereta Nordentoft (Copenhagen University, Denmark) and team.
To investigate clinical and social predictors of recovery from psychosis, the researchers studied data on 255 patients with schizophrenia-spectrum disorders, aged between 18 and 45 years at baseline, who participated in the Danish OPUS trial - a long-term prospective follow-up study of first-episode psychosis patients.
Data on sociodemographic factors were collected at baseline, and the participants were interviewed at various stages over the 5-year follow-up period using the Premorbid Adjustment Scale (PAS), the Global Assessment of Functioning (GAF), the Scale for Assessment of Positive Symptoms (SAP), the Scale for Assessment of Negative symptoms (SANS), and the Social Network Schedule.
Recovery was defined as stable remission of both negative and psychotic symptoms during the previous 2 years, not having been hospitalized or not having lived in a supported housing facility during the previous 2 years, having a GAF score of more than 60, and having a job or studying.
At 5 years, 40 (15.7%) patients were defined as recovered, and 76 (29.8%) had a job or were studying, of whom 20 were still experiencing symptoms of psychosis.
Factors that significantly predicted recovery at 5 years included female gender (odds ratio [OR]=2.4 versus male gender) and growing up with both parents (OR=2.6 versus growing up with one parent). Having finished high school as opposed to not having finished high school was also associated with a greater chance for recovery (OR =2.6), as was having a partner (OR= 2.7), and working at baseline (OR =2.1). Furthermore, for every friend a patient had, their chances for recovery increased 1.1-fold.
High GAF scores and low levels of negative symptoms were also associated with an increased likelihood of recovery.
Nordentoft and team conclude in the journal Schizophrenia Research: "Our findings suggest that a stable social life with normal social functioning has a predictive value for good outcome. These measures might be influenced by negative symptoms, but in the multivariate analysis with negative symptoms included they have an independent effect.
"Also our findings suggest that, after first-episode psychosis, some patients can still experience psychotic symptoms, but have a job and a fairly stable life."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Mark Cowen