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Early recovery in the first 24 months of treatment in first-episode schizophrenia-spectrum disorders.
npj Schizophrenia ( IF 5.7 ) Pub Date : 2020-01-08 , DOI: 10.1038/s41537-019-0091-y
Lebogang Phahladira 1 , Hilmar K Luckhoff 1 , Laila Asmal 1 , Sanja Kilian 1 , Frederika Scheffler 1 , Stefan du Plessis 1 , Bonginkosi Chiliza 2 , Robin Emsley 1
Affiliation  

Studies assessing the treatment outcomes in first-episode schizophrenia have reported mixed results. While symptom improvement is frequently robust, when other domains are considered outcomes are generally poorer. We explored response trajectories, rates and predictors of recovery in the domains of core psychopathology, clinician-rated social and occupational functioning and patient-rated quality of life over 24 months of treatment in 98 patients with first-episode schizophrenia spectrum disorders who were treated with a long-acting antipsychotic medication. There was robust improvement in core psychopathology (effect size d = 3.36) and functionality (d = 1.78), with most improvement occurring within the first six months of treatment. In contrast, improvement in subjective quality of life was less marked (d = 0.37) and slower, only reaching significance after 12 months of treatment. Symptom remission was achieved by 70% of patients and over half met our criteria for functional remission and good quality of life. However, only 29% met the full criteria for recovery. Patients who met the recovery criteria had better premorbid adjustment, were less likely to be of mixed ethnicity and substance use emerged as the only modifiable predictor of recovery. Only 9% of our sample achieved both functional remission and good quality of life despite not being in symptom remission. We found high rates of symptom remission, functional remission and good quality of life in patients, although relatively few achieved recovery by meeting all three of the outcome criteria. Symptom remission is not a necessary prerequisite for functional remission and good quality of life, although few non-remitters achieve other recovery criteria.

中文翻译:

在首发精神分裂症频谱疾病中,治疗的前24个月可早日康复。

评估首发精神分裂症治疗效果的研究报告了好坏参半的结果。虽然症状改善通常是有效的,但是当考虑其他方面时,结果通常较差。我们在98例首发精神分裂症谱系障碍患者中研究了核心精神病理学,临床医师评定的社会和职业功能以及患者评定的24个月内生活质量方面的反应轨迹,恢复率和预测因素一种长效抗精神病药。核心精神病理学(效果大小d = 3.36)和功能性(d = 1.78)有了明显的改善,大部分改善发生在治疗的前六个月内。相反,主观生活质量的改善较不明显(d = 0.37),而较慢,只有在治疗12个月后才有意义。70%的患者实现了症状缓解,超过一半的患者符合我们的功能缓解和良好生活质量标准。但是,只有29%的人符合恢复的全部标准。符合恢复标准的患者病前调整较好,混合种族的可能性较小,并且使用药物作为恢复的唯一可更改的预测指标。尽管没有症状缓解,我们的样本中只有9%达到了功能缓解和良好的生活质量。我们发现患者的症状缓解,功能缓解和良好的生活质量较高,尽管通过满足所有三个结局标准而实现的恢复相对较少。症状缓解不是功能缓解和良好生活质量的必要先决条件,
更新日期:2020-01-08
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