Cargando…

F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA

BACKGROUND: Metanalisis show that global recovery, (a state of clinical and social well functioning) is achieved by 13.5% patients (25%-75% quartiles 8.1–20%) (Jääskeläinen, 2013) diagnosed with schizophrenia. It has also been suggested that recovery is higher in low or lower middle-income countries...

Descripción completa

Detalles Bibliográficos
Autores principales: Iruretagoyena, Barbara, Crossley, Nicolas, Undurraga, Juan, Castañeda, Carmen, Gallardo, Carlos, Mancilla, Felipe, Gonzalez, Alfonso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887291/
http://dx.doi.org/10.1093/schbul/sby017.658
_version_ 1783312268280201216
author Iruretagoyena, Barbara
Crossley, Nicolas
Undurraga, Juan
Castañeda, Carmen
Gallardo, Carlos
Mancilla, Felipe
Gonzalez, Alfonso
author_facet Iruretagoyena, Barbara
Crossley, Nicolas
Undurraga, Juan
Castañeda, Carmen
Gallardo, Carlos
Mancilla, Felipe
Gonzalez, Alfonso
author_sort Iruretagoyena, Barbara
collection PubMed
description BACKGROUND: Metanalisis show that global recovery, (a state of clinical and social well functioning) is achieved by 13.5% patients (25%-75% quartiles 8.1–20%) (Jääskeläinen, 2013) diagnosed with schizophrenia. It has also been suggested that recovery is higher in low or lower middle-income countries compared to high and upper middle income countries. However, this is only based in a few studies. We here looked at the number of patients with first episode psychosis that met recovery criteria based on both clinical and social domains in a South American early intervention sample. We also examined whether recovery was associated with factors such as diagnoses, sex, education, substance use and duration of untreated psychosis. METHODS: This is a cross-sectionall study in an outpatient First Episode Psychosis program in Chile. We gathered information on different aspects of the patients, including sociodemographic, clinical, functional and metabolic status. FAST (Functional Assessment Short Test) and SS-DSM5 (Symptom Severity Scale of the DSM5 for Schizophrenia) were applied to patients. Global recovery was defined as the presence for at least 6 months of: 1. Working or studying. 2. SS-DSM5 scale with no dimension with score over two. 3. FAST with score under 21 (which correlates with GAF > 61). The group who met recovery criteria (improvement in both clinical and social domains) was identified, and correlation and regression analysis were performed to explore the association between global recovery and selected variables. RESULTS: We included 80 patients in this study. Overall, 20% met global recovery criteria. Patients who did not accomplish recovery did so because of being unemployed (80.6%), not studying (79.7%), or scoring above threshold in SS-DSM5 cognitive (54.7%) and negative (54.7%) symptom domains. Univariate correlation analyses showed a significant association of global recovery with recreational drug use, diagnoses, and duration of untreated psychosis (all corrected for multiple comparisons). After multiple regression analysis including these variables, age and gender, the only one associated with recovery was shorter duration of untreated psychosis (p=0.02) OR 0.616 (IC95% 0.409–0.925). DISCUSSION: The number of patients achieving global recovery is consistent with the one reported for schizophrenia in previous meta-analysis and with studies on recovery after first episode psychosis (16.6% (25%-75% quartiles 9–20.4)) (Jääskeläinen, 2013). Negative and cognitive symptoms frequently impair patient recovery. On the other hand the duration of untreated psychosis shows itself as one of the most important characteristics related with functional prognoses.
format Online
Article
Text
id pubmed-5887291
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-58872912018-04-11 F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA Iruretagoyena, Barbara Crossley, Nicolas Undurraga, Juan Castañeda, Carmen Gallardo, Carlos Mancilla, Felipe Gonzalez, Alfonso Schizophr Bull Abstracts BACKGROUND: Metanalisis show that global recovery, (a state of clinical and social well functioning) is achieved by 13.5% patients (25%-75% quartiles 8.1–20%) (Jääskeläinen, 2013) diagnosed with schizophrenia. It has also been suggested that recovery is higher in low or lower middle-income countries compared to high and upper middle income countries. However, this is only based in a few studies. We here looked at the number of patients with first episode psychosis that met recovery criteria based on both clinical and social domains in a South American early intervention sample. We also examined whether recovery was associated with factors such as diagnoses, sex, education, substance use and duration of untreated psychosis. METHODS: This is a cross-sectionall study in an outpatient First Episode Psychosis program in Chile. We gathered information on different aspects of the patients, including sociodemographic, clinical, functional and metabolic status. FAST (Functional Assessment Short Test) and SS-DSM5 (Symptom Severity Scale of the DSM5 for Schizophrenia) were applied to patients. Global recovery was defined as the presence for at least 6 months of: 1. Working or studying. 2. SS-DSM5 scale with no dimension with score over two. 3. FAST with score under 21 (which correlates with GAF > 61). The group who met recovery criteria (improvement in both clinical and social domains) was identified, and correlation and regression analysis were performed to explore the association between global recovery and selected variables. RESULTS: We included 80 patients in this study. Overall, 20% met global recovery criteria. Patients who did not accomplish recovery did so because of being unemployed (80.6%), not studying (79.7%), or scoring above threshold in SS-DSM5 cognitive (54.7%) and negative (54.7%) symptom domains. Univariate correlation analyses showed a significant association of global recovery with recreational drug use, diagnoses, and duration of untreated psychosis (all corrected for multiple comparisons). After multiple regression analysis including these variables, age and gender, the only one associated with recovery was shorter duration of untreated psychosis (p=0.02) OR 0.616 (IC95% 0.409–0.925). DISCUSSION: The number of patients achieving global recovery is consistent with the one reported for schizophrenia in previous meta-analysis and with studies on recovery after first episode psychosis (16.6% (25%-75% quartiles 9–20.4)) (Jääskeläinen, 2013). Negative and cognitive symptoms frequently impair patient recovery. On the other hand the duration of untreated psychosis shows itself as one of the most important characteristics related with functional prognoses. Oxford University Press 2018-04 2018-04-01 /pmc/articles/PMC5887291/ http://dx.doi.org/10.1093/schbul/sby017.658 Text en © Maryland Psychiatric Research Center 2018. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Iruretagoyena, Barbara
Crossley, Nicolas
Undurraga, Juan
Castañeda, Carmen
Gallardo, Carlos
Mancilla, Felipe
Gonzalez, Alfonso
F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title_full F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title_fullStr F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title_full_unstemmed F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title_short F127. GLOBAL RECOVERY IN A FIRST EPISODE PSYCHOSIS PROGRAM IN SOUTH AMERICA
title_sort f127. global recovery in a first episode psychosis program in south america
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887291/
http://dx.doi.org/10.1093/schbul/sby017.658
work_keys_str_mv AT iruretagoyenabarbara f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT crossleynicolas f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT undurragajuan f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT castanedacarmen f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT gallardocarlos f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT mancillafelipe f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica
AT gonzalezalfonso f127globalrecoveryinafirstepisodepsychosisprograminsouthamerica