Outcome Predictors in First-Episode Psychosis Depend on Disorder

Baseline factors predicting functional outcome after first-episode psychosis differ depending on whether the psychosis is caused by schizophrenia or another type of disorder, a team of researchers in Spain has found.

In a study that enrolled 95 people with first-episode psychosis who were followed up for 2 years, processing speed significantly predicted most functional outcome measures in patients who were found to have schizophrenia spectrum disorders.

Among people who were later diagnosed with bipolar disorder and other nonschizophrenic syndromes, however, visuospatial functioning (spatial orientation, motion detection, and stimulus perception) was the only significant predictor of functional outcomes.

For both groups together, higher levels of negative symptoms at baseline predicted worse functional outcomes, a finding consistent with those of many previous studies.

For the current study, published in the Journal of Psychiatric Research (2012;46:774-81), Javier Peña of the University of Deusto in Bilbao, Spain, and colleagues recruited 109 patients who were admitted to one psychiatric hospital’s first-episode psychosis unit.

After patients were stabilized for positive symptoms, each underwent an extensive neuropsychological evaluation and completed a battery of cognitive tests. Subjects’ functional outcomes were measured using three standardized exams: the WHODAS (WHO Disability Assessment Schedule), the GAF (Global Assessment of Functioning) scale, and the CGI (Clinical Global Impression) scale.

Of the 95 subjects who completed follow-up and were entered into analysis, 58 were ultimately diagnosed with schizophrenia syndromes and 37 were diagnosed with nonschizophrenia psychotic syndromes (including bipolar disorder, delusional disorder, and acute/transient psychosis).

By: JENNIE SMITH, Clinical Psychiatry News Digital Network


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