Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)

BMC Psychiatry

Päivi Jalo¹  Raimo K. R. Salokangas²  Maija Walta²  Janina Paju²  Heikki Laurikainen²  Reetta-Liina Armio²  Anna Toivonen²  Markus Heinimaa²  Tiina From²  Tuula Ilonen²  Jarmo Hietala³  Sinikka Luutonen³  Lauri Tuominen⁴ 

[1]Department of Psychiatry, Turku University Hospital, Turku, Finland

[2]Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, FIN-20700, Turku, Finland

[3]Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, FIN-20700, Turku, Finland

[4]Department of Psychiatry, Turku University Hospital, Turku, Finland

[5]Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, FIN-20700, Turku, Finland

[6]Royal Ottawa Mental Health Centre, Ottawa, Canada

关键词: Functional outcome;    Psychotic disorders;    Clinical high risk of psychosis;    Premorbid adjustment;    Disorganization symptoms;    Negative symptoms;   

DOI  :  10.1186/s12888-021-03516-4

来源: Springer

【 摘 要 】

BackgroundFunctional recovery of patients with clinical and subclinical psychosis is associated with clinical, neuropsychological and developmental factors. Less is known about how these factors predict functional outcomes in the same models. We investigated functional outcomes and their predictors in patients with first-episode psychosis (FEP) or a confirmed or nonconfirmed clinical high risk of psychosis (CHR-P vs. CHR-N).MethodsAltogether, 130 patients with FEP, 60 patients with CHR-P and 47 patients with CHR-N were recruited and extensively examined at baseline (T0) and 9 (T1) and 18 (T2) months later. Global Assessment of Functioning (GAF) at T0, T1 and T2 and psychotic, depression, and anxiety symptoms at T1 and T2 were assessed. Functional outcomes were predicted using multivariate repeated ANOVA.ResultsDuring follow-up, the GAF score improved significantly in patients with FEP and CHR-P but not in patients with CHR-N. A single marital status, low basic education level, poor work situation, disorganization symptoms, perceptual deficits, and poor premorbid adjustment in patients with FEP, disorganization symptoms and poor premorbid adjustment in patients with CHR-P, and a low basic education level, poor work situation and general symptoms in patients with CHR-N predicted poor functional outcomes. Psychotic symptoms at T1 in patients with FEP and psychotic and depression symptoms at T1 and anxiety symptoms at T2 in patients with CHR-P were associated with poor functioning.ConclusionsIn patients with FEP and CHR-P, poor premorbid adjustment and disorganization symptomatology are common predictors of the functional outcome, while a low education level and poor work situation predict worse functional outcomes in patients with FEP and CHR-N. Interventions aimed at improving the ability to work and study are most important in improving the functioning of patients with clinical or subclinical psychosis.

【 授权许可】

CC BY