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.
Similar content being viewed by others
References
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
Angermeyer MC, Kühn L, Goldstein JM (1990) Gender and the course of schizophrenia: differences in treated outcomes. Schizophr Bull 16:293–307
Andreasen NC (1983) The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa, Iowa City, Iowa
Andreasen NC (1984) The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa, Iowa City, Iowa
Cannon–Spoor H, Potkin SG, Wyatt RJ (1982) Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 8:471–484
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
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
Fenton WS, Byler CR, Heinssen RK (1997). Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull 23:637–651
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
Gaebel W, Frommann N (2000) Long–term course in schizophrenia: concepts, methods and research strategies. Acta Psych Scand 102(Suppl. 407):49–53
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
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
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
Harrigan SM, McGorry PD, Krstev H (2003) Does treatment delay in first–episode psychosis really matter? Psychol Med 33:97–110
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
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
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
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
Linszen DH, Dingemans PM, Lenior ME (1994) Cannabis abuse and the course of recent–onset schizophrenic patients. Arch Gen Psychiatry 51:273–279
Lukoff D, Nuechterlein KH, Ventura J (1986) Manual for the Expanded Brief Psychiatric Rating Scale. Schizophr Bull 12:594–602
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
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
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
Novak–Grubic V, Tavcar R (2002) Predictors of relapse in males with first episode schizophrenia, schizophreniform and schizoaffective disorder. Eur Psychiatry 17:148–154
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
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
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
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
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
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
Author information
Authors and Affiliations
Corresponding author
Rights 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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00406-005-0598-2