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Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients

Introduction: Clinical insight constitutes a useful marker of the progress and outcome of the First Episode of Psychosis (FEP), and lack of insight has been associated with more severe psychopathology, treatment non-adherence, and rehospitalization/relapse. In this study, we aimed to further investi...

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Autores principales: Vlachos, Ilias I., Selakovic, Mirjana, Ralli, Irene, Hatzimanolis, Alexandros, Xenaki, Lida-Alkisti, Dimitrakopoulos, Stefanos, Soldatos, Rigas-Filippos, Foteli, Stefania, Nianiakas, Nikos, Kosteletos, Ioannis, Stefanatou, Pentagiotissa, Ntigrintaki, Angeliki-Aikaterini, Triantafyllou, Theoni-Fani, Voulgaraki, Marina, Ermiliou, Vassiliki, Mantonakis, Leonidas, Kollias, Konstantinos, Stefanis, Nikos C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342885/
https://www.ncbi.nlm.nih.gov/pubmed/37445295
http://dx.doi.org/10.3390/jcm12134261
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author Vlachos, Ilias I.
Selakovic, Mirjana
Ralli, Irene
Hatzimanolis, Alexandros
Xenaki, Lida-Alkisti
Dimitrakopoulos, Stefanos
Soldatos, Rigas-Filippos
Foteli, Stefania
Nianiakas, Nikos
Kosteletos, Ioannis
Stefanatou, Pentagiotissa
Ntigrintaki, Angeliki-Aikaterini
Triantafyllou, Theoni-Fani
Voulgaraki, Marina
Ermiliou, Vassiliki
Mantonakis, Leonidas
Kollias, Konstantinos
Stefanis, Nikos C.
author_facet Vlachos, Ilias I.
Selakovic, Mirjana
Ralli, Irene
Hatzimanolis, Alexandros
Xenaki, Lida-Alkisti
Dimitrakopoulos, Stefanos
Soldatos, Rigas-Filippos
Foteli, Stefania
Nianiakas, Nikos
Kosteletos, Ioannis
Stefanatou, Pentagiotissa
Ntigrintaki, Angeliki-Aikaterini
Triantafyllou, Theoni-Fani
Voulgaraki, Marina
Ermiliou, Vassiliki
Mantonakis, Leonidas
Kollias, Konstantinos
Stefanis, Nikos C.
author_sort Vlachos, Ilias I.
collection PubMed
description Introduction: Clinical insight constitutes a useful marker of the progress and outcome of the First Episode of Psychosis (FEP), and lack of insight has been associated with more severe psychopathology, treatment non-adherence, and rehospitalization/relapse. In this study, we aimed to further investigate the possible role of insight as a predictor of relapse, its relation to diagnosis, and other parameters of positive psychotic symptomatology (delusions, hallucinations, and suspiciousness). Methods: The Athens FEP study employed a prospective, longitudinal cohort design in which consecutive newly diagnosed patients with psychosis were interviewed and asked to voluntarily participate after completing informed consent. A total of 88/225 patients were examined at three different time points (baseline, month, and year). Their scores in the relevant items of the Positive and Negative Syndrome Scale (PANSS) were compared (G12 for insight, P1 for delusions, P3 for hallucinations, and P6 for suspiciousness), and they were further associated to diagnosis and the outcome at the end of the year (remission/relapse). Results: In total, 22/88 patients with relapse at the year had greater scores in G12 for both the month and the year, and this finding was corroborated after adjusting the statistical analysis for demographics, diagnosis, social environment, and depression via multiple logistic regression analysis. Moreover, delusions and suspiciousness were significantly higher in patients diagnosed with non-affective psychosis compared to those diagnosed with affective psychosis (p < 0.001) at the first month. Conclusions: Lack of insight at the first month may serve as a predictor of relapse at the year.
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spelling pubmed-103428852023-07-14 Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients Vlachos, Ilias I. Selakovic, Mirjana Ralli, Irene Hatzimanolis, Alexandros Xenaki, Lida-Alkisti Dimitrakopoulos, Stefanos Soldatos, Rigas-Filippos Foteli, Stefania Nianiakas, Nikos Kosteletos, Ioannis Stefanatou, Pentagiotissa Ntigrintaki, Angeliki-Aikaterini Triantafyllou, Theoni-Fani Voulgaraki, Marina Ermiliou, Vassiliki Mantonakis, Leonidas Kollias, Konstantinos Stefanis, Nikos C. J Clin Med Article Introduction: Clinical insight constitutes a useful marker of the progress and outcome of the First Episode of Psychosis (FEP), and lack of insight has been associated with more severe psychopathology, treatment non-adherence, and rehospitalization/relapse. In this study, we aimed to further investigate the possible role of insight as a predictor of relapse, its relation to diagnosis, and other parameters of positive psychotic symptomatology (delusions, hallucinations, and suspiciousness). Methods: The Athens FEP study employed a prospective, longitudinal cohort design in which consecutive newly diagnosed patients with psychosis were interviewed and asked to voluntarily participate after completing informed consent. A total of 88/225 patients were examined at three different time points (baseline, month, and year). Their scores in the relevant items of the Positive and Negative Syndrome Scale (PANSS) were compared (G12 for insight, P1 for delusions, P3 for hallucinations, and P6 for suspiciousness), and they were further associated to diagnosis and the outcome at the end of the year (remission/relapse). Results: In total, 22/88 patients with relapse at the year had greater scores in G12 for both the month and the year, and this finding was corroborated after adjusting the statistical analysis for demographics, diagnosis, social environment, and depression via multiple logistic regression analysis. Moreover, delusions and suspiciousness were significantly higher in patients diagnosed with non-affective psychosis compared to those diagnosed with affective psychosis (p < 0.001) at the first month. Conclusions: Lack of insight at the first month may serve as a predictor of relapse at the year. MDPI 2023-06-25 /pmc/articles/PMC10342885/ /pubmed/37445295 http://dx.doi.org/10.3390/jcm12134261 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vlachos, Ilias I.
Selakovic, Mirjana
Ralli, Irene
Hatzimanolis, Alexandros
Xenaki, Lida-Alkisti
Dimitrakopoulos, Stefanos
Soldatos, Rigas-Filippos
Foteli, Stefania
Nianiakas, Nikos
Kosteletos, Ioannis
Stefanatou, Pentagiotissa
Ntigrintaki, Angeliki-Aikaterini
Triantafyllou, Theoni-Fani
Voulgaraki, Marina
Ermiliou, Vassiliki
Mantonakis, Leonidas
Kollias, Konstantinos
Stefanis, Nikos C.
Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title_full Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title_fullStr Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title_full_unstemmed Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title_short Role of Clinical Insight at First Month in Predicting Relapse at the Year in First Episode of Psychosis (FEP) Patients
title_sort role of clinical insight at first month in predicting relapse at the year in first episode of psychosis (fep) patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342885/
https://www.ncbi.nlm.nih.gov/pubmed/37445295
http://dx.doi.org/10.3390/jcm12134261
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