Stability and development of psychotic symptoms and the use of antipsychotic medication – long-term follow-up. Issue 12 (6th April 2017)

• Record Type: Journal Article
• Authors: Gotfredsen, D. R.; Wils, R. S.; Hjorthøj, C.; Austin, S. F.; Albert, N.; Secher, R. G.; Thorup, A. A. E.; Mors, O.; Nordentoft, M.
• Is Part Of: Psychological medicine. Volume 47:Issue 12(2017)
• Page Start: 2118
• Page End: 2129
• Publication Date: 2017-04-06
• Subjects: Schizophrenia, -- psychotic illness, -- medication, -- long-term outcome.; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291717000563
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract : 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.