Predictors of short- and long-term outcome in schizophrenia identified
MedWire News: Finnish researchers have identified a number of clinical and sociodemographic factors at the time of illness onset that are associated with short- and long-term outcomes in patients with schizophrenia.
Writing in European Psychiatry, P Juola (University of Oulu) and team explain that "since the outcome in schizophrenia is heterogeneous and often poor, identification of specific predictors of outcome would be useful in clinical practice."
The team therefore studied data on 103 patients (57% men) with schizophrenia from the Northern Finland 1966 Birth Cohort who were followed up for an average of 16.4 years after a first hospital admission for psychosis.
Clinical and demographic factors at time of the first admission were compared with short- (2 years) and long-term (minimum 10 years) outcomes with regard to remission and rehospitalization for psychosis.
Logistic regression analyses revealed that the only significant predictor for outcome at 2 years was insidious illness onset, which was associated with 2.7-fold increased risk for rehospitalization after initial discharge.
However, a number of factors at the time of first hospital admission were significantly associated with long-term outcomes.
Indeed, patients who were single and those who were aged less than 22 years at illness onset were significantly less likely to achieve remission than patients who were in a relationship and those who were aged at least 22 years at the time of illness onset, both at odds ratios (ORs) of 0.2.
Furthermore, insidious illness onset and the presence of suicidal ideation at initial hospital admission predicted rehospitalization in the long term, at ORs of 2.7 and 4.7, respectively.
The researchers also note that rehospitalization in the first 2 years after initial discharge predicted further hospital admission for psychosis in the long term, at an OR of 4.4.
Juola and team conclude: "These results should be taken into account in clinical practice by monitoring and paying special attention to patients manifesting these prognostic factors."
They add: "Although many of the predictors found in this study are not easily modifiable, with the help of early intervention and adequate psychosocial support, it might be possible to affect some of them."
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By Mark Cowen