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02-02-2011 | Mental health | Article

Early treatment reduces risk for second psychotic episode

Abstract

Free abstract

MedWire News: Early treatment is associated with a significantly reduced risk for further psychotic episodes in first-episode psychosis (FEP) patients, research shows.

The findings emphasize "the importance of early intervention efforts which are likely to improve the long-term course of psychosis - beyond the level that would be accomplished by similar interventions initiated later - by means of reducing the biological and psychosocial damages of the untreated illness," say the researchers.

To investigate factors associated with no further recurrence after an initial episode of psychosis, M Alvarez-Jimenez (University of Melbourne, Australia) and team studied data on 274 patients, aged an average of 21.8 years, who were treated for a first psychotic episode and followed-up for 7.5 years.

The patients were assessed for duration of untreated psychosis and other clinical and sociodemographic variables at baseline, and the occurrence of further episodes of psychosis over follow-up were recorded.

In total, 46 (16.5%) patients experienced no further psychotic episodes during the 7.5-year study period, and were classified as single episode psychosis (SEP) patients.

The researchers found that a short duration (less than 60 days) of untreated psychosis significantly predicted SEP, at an odds ratio (OR) of 3.89 compared with a longer period of untreated psychosis.

Other major factors that significantly predicted SEP included no parental loss (OR=5.03) and reduced time to treatment response.

The findings remained significant after accounting for suddenness of psychosis onset, premorbid adjustment, baseline psychopathology, age at onset, and gender.

Alvarez-Jimenez et al conclude in the journal Schizophrenia Research: "Early treatment (within 2 months of onset of psychotic symptoms) and social support significantly reduce vulnerability to subsequent psychotic episodes."

They add: "Future studies need to investigate the interplay between biological factors (ie, sensitized dopaminergic system), environmental variables (ie, exposure to trauma, stigma, and discrimination), and psychological attributes (ie, cognitive schemata) in order to elucidate the processes underlying the vulnerability to recurrent psychotic episodes."

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

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