Skip to main content

Advertisement

Log in

One year outcome in first episode schizophrenia

Predictors of relapse

  • ORIGINAL PAPER
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

The aim of this study was to identify the predictors of outcome at one year follow–up after the first psychotic episode of schizophrenia. Seventy–nine first–episode schizophrenia patients were assessed monthly with the Brief Psychiatric Rating Scale (BPRS), Scale for Assessment of Positive Symptoms (SAPS), and Scale for Assessment of Negative Symptoms (SANS) after discharge from their first hospitalization. Outcome measures were presence of relapse and rehospitalization, level of global functioning, employment status and severity of symptoms at one year. A total of 33% of the patients had a relapse, and 12.1% were rehospitalized during one year follow–up. Premorbid childhood functionality was worse in patients who had relapse, but there was no correlation between premorbid adjustment scores and BPRS, SANS and SAPS scores at one year. There was no difference in duration of untreated psychosis (DUP) between patients who had relapse and not; however, the patients who had double relapse, had longer DUP than those without relapse. The time period between discharge and rehospitalization was shorter in patients with longer DUP. Functionality in childhood and noncompliance to the treatment independently contributed to the relapse rate. Functionality in late adolescence independently contributed to the Global Assessment of Functioning (GAF) scale score at one year and the GAF score at discharge appeared as a predictor of employment. The results of the present study suggest that treatment compliance and early premorbid adjustment level seem to be important predictors of relapse rate in first episode schizophrenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Altamura AC, Basetti R, Sassella F, Salvadori D, Mundo E (2001) Duration of untreated psychosis as a predictor of outcome in first-episode schizophrenia: a retrospective study. Schizophr Res 52:29–36

    Article  CAS  PubMed  Google Scholar 

  2. Angermeyer MC, Kühn L, Goldstein JM (1990) Gender and the course of schizophrenia: differences in treated outcomes. Schizophr Bull 16:293–307

    CAS  PubMed  Google Scholar 

  3. Andreasen NC (1983) The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa, Iowa City, Iowa

  4. Andreasen NC (1984) The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa, Iowa City, Iowa

  5. Cannon–Spoor H, Potkin SG, Wyatt RJ (1982) Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 8:471–484

    Google Scholar 

  6. Doering S, Muller E, Kopcke W, Pietzcker A, Gaebel W, Linden M, Muller P, Muller-Spahn F, Tegeler J, Schussler G (1998) Predictors of relapse and rehospitalization in schizophrenia and schizoaffective disorder. Schizophr Bull 24:87–98

    CAS  PubMed  Google Scholar 

  7. Drake RJ, Haley CJ, Akhtar S, Lewis SW (2000) Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry 177:511–515

    Article  CAS  PubMed  Google Scholar 

  8. Fenton WS, Byler CR, Heinssen RK (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 23:637–651

    CAS  PubMed  Google Scholar 

  9. First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured Clinical Interview for DSM–IV Axis I disorders (SCID–I), Clinical Version. American Psychiatric Press, Washington, DC

  10. Gaebel W, Frommann N (2000) Long–term course in schizophrenia: concepts, methods and research strategies. Acta Psych Scand 102(Suppl. 407):49–53

    Google Scholar 

  11. Gaebel W, Möller HJ, Buchkremer G, Ohmann C, Riesbeck M, Wöwler W, Wilmsdroff, M, Bottlender R, Klingberg S (2004) Pharmacological long–term treatment strategies in first episode schizophrenia. European Arch Psychiatry Clin Neurosci 254:129–140

    Google Scholar 

  12. Geddes J, Mercer G, Frith CD, MacMillan F, Owens DGC, Johnstone EC (1994) Prediction of outcome following a first episode of schizophrenia. A follow–up study of Northwick Park first episode study subjects. Br J Psychiatry 165:664–668

    CAS  PubMed  Google Scholar 

  13. Hafner H, Maurer K, Loffler W, Riecher–Rössler A (1993) The influence of age and sex on the onset of early course of schizophrenia. Br J Psychiatry 162:80–86

    CAS  PubMed  Google Scholar 

  14. Harrigan SM, McGorry PD, Krstev H (2003) Does treatment delay in first–episode psychosis really matter? Psychol Med 33:97–110

    Article  CAS  PubMed  Google Scholar 

  15. Kampman O, Anttila S, Illi A, Mattila KM, Rontu R, Leinonen E, Lehtimaki T (2004) Interaction of tumor necrosis alpha–G308A and epidermal growth factor gene polymorphisms in earlyonset schizophrenia. Eur Arch Psychiatry Clin Neurosci

  16. Kane JM, Rifkin A, Quitkin F, Nayak D, Ramos LJ (1982) Fluphenazine vs. placebo in patients with remitted acute firstepisode schizophrenia. Arch Gen Psychiatry 39:70–73

    CAS  PubMed  Google Scholar 

  17. Kitamura H, Matsuzawa H, Shiori T, Someya T, Kwee IL, Nakada T (2005) Diffusion tensor analysis in chronic schizophrenia. A preliminary study on a high–field (3. 0T) system. Eur Arch Psychiatry Clin Neurosci

  18. Larsen TK, Moe LC, Vibe–Hansen L, Johannessen JO (2000) Premorbid functioning versus duration of untreated psychosis in one year outcome in first–episode psychosis. Schizophr Res 45:1–9

    Article  CAS  PubMed  Google Scholar 

  19. Linszen DH, Dingemans PM, Lenior ME (1994) Cannabis abuse and the course of recent–onset schizophrenic patients. Arch Gen Psychiatry 51:273–279

    CAS  PubMed  Google Scholar 

  20. Lukoff D, Nuechterlein KH, Ventura J (1986) Manual for the Expanded Brief Psychiatric Rating Scale. Schizophr Bull 12:594–602

    Google Scholar 

  21. Malla AK, Norman RMG, Machanda R, Ahmed MR, Scholten D, Harricaran R, Cortese L, Takhar J (2002) One year outcome in first episode psychosis: influence of DUP and other predictors. Schizophr Res 54:231–242

    Article  PubMed  Google Scholar 

  22. Marder SR, Mebane A, Chien CP, et al. (1983) A comparison of patients who refuse and consent to neuroleptic treatment. Am J Psychiatry 140:470–472

    CAS  PubMed  Google Scholar 

  23. Mojtabai R, Lavelle J, Gibson PJ, Sohler NL, Craig TJ, Carlson GA, Bromet EJ (2002) Gaps in use of antipsychotics after discharge by first–admission patients with schizophrenia, 1989 to 1996. Psychiatr Serv 53:337–339

    Article  PubMed  Google Scholar 

  24. Novak–Grubic V, Tavcar R (2002) Predictors of relapse in males with first episode schizophrenia, schizophreniform and schizoaffective disorder. Eur Psychiatry 17:148–154

    PubMed  Google Scholar 

  25. Nuechterlein KH, Dawson ME, Gitlin M, Ventura J, Goldstein MJ, Snyder KS, Yee JM, Mintz J (1992) Developmental processes in schizophrenic disorders: longitudinal studies of vulnerability and stress. Schizophr Bull 18:387–425

    CAS  PubMed  Google Scholar 

  26. Rabiner CJ, Wegner JT, Kane JM (1986) Outcome study of first episode psychosis: I. Relapse rates after one year. Am J Psychiatry 143:1155–1158

    CAS  PubMed  Google Scholar 

  27. Robinson D, Woerner MG, Alvir JMJ, Bilder R, Goldman R, Geisler S, Koreen A, Sheitman, Chakos M, Mayerhoff D, Lieberman JA (1999) Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry 56:241–247

    CAS  PubMed  Google Scholar 

  28. Szymanski SR, Lieberman JA, Alvir J, Mayerhoff D, Loebel A, Geisler S, Chakos M, Koreen A, Jody D, Kane J, Woerner M, Cooper T (1995) Gender differences in onset of illness, treatment response, course and biologic indexes in first–episode schizophrenic patients. Am J Psychiatry 152:698–703

    CAS  PubMed  Google Scholar 

  29. Ucok A, Polat A, Cakir S, Genc A, Turan N (2004) Duration of untreated psychosis may predict acute treatment response in first–episode schizophrenia. J Psych Res 38:163–168

    Google Scholar 

  30. Usall J, Ochoa S, Araya S, Marquez M, Nedes Group (2003) Gender differences and outcome in schizophrenia: a 2–year followup study in a large community sample. European Psychiatry 18:282–284

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Üçok.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Üçok, A., Polat, A., Çakır, S. et al. One year outcome in first episode schizophrenia. Eur Arch Psychiatry Clin Neurosci 256, 37–43 (2006). https://doi.org/10.1007/s00406-005-0598-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-005-0598-2

Key words

Navigation