Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up
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Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up. / Gotfredsen, D R; Wils, R S; Hjorthøj, C; Austin, S F; Albert, N; Secher, R G; Thorup, A A E; Mors, O; Nordentoft, M.
In: Psychological Medicine, Vol. 47, No. 12, 09.2017, p. 2118-2129.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up
AU - Gotfredsen, D R
AU - Wils, R S
AU - Hjorthøj, C
AU - Austin, S F
AU - Albert, N
AU - Secher, R G
AU - Thorup, A A E
AU - Mors, O
AU - Nordentoft, M
PY - 2017/9
Y1 - 2017/9
N2 - BACKGROUND: Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis.METHOD: The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark.RESULTS: At all follow-ups, a large proportion (20-30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77-96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56-78%) probability of being in this group at the consecutive follow-up.CONCLUSIONS: A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.
AB - BACKGROUND: Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis.METHOD: The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark.RESULTS: At all follow-ups, a large proportion (20-30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77-96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56-78%) probability of being in this group at the consecutive follow-up.CONCLUSIONS: A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.
KW - Journal Article
U2 - 10.1017/S0033291717000563
DO - 10.1017/S0033291717000563
M3 - Journal article
C2 - 28382874
VL - 47
SP - 2118
EP - 2129
JO - Psychological Medicine
JF - Psychological Medicine
SN - 0033-2917
IS - 12
ER -
ID: 186528567