Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis. Issue 1 (3rd November 2021)

• Record Type: Journal Article
• Authors: Catalan, Ana; Richter, Anja; Salazar de Pablo, Gonzalo; Vaquerizo-Serrano, Julio; Mancebo, Gonzalo; Pedruzo, Borja; Aymerich, Claudia; Solmi, Marco; González-Torres, Miguel Á.; Gil, Patxi; McGuire, Philip; Fusar-Poli, Paolo
• Is Part Of: European psychiatry. Volume 64:Issue 1(2021)
• Publication Date: 2021-11-03
• Subjects: First-episode psychosis -- predictors -- psychosis -- recovery -- remission; Psychiatry -- Periodicals; Mental illness -- Periodicals; Electronic journals; 616.89
• DOI: 10.1192/j.eurpsy.2021.2246
• Languages: English
• ISSNs: 0924-9338

Abstract

Abstract: Background: To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods: A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I 2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results: One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49–58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27–36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions: Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.