Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome

Erik Simonsen, Wenche ten Welden Hegelstad, Tor Ketil Larsen, B Auestad, Julie Evensen, Ulrik Helt Haahr, Inge Joa, Jan Olav Johannessen, Johannes Langeveld, Ingrid Melle, Stein Opjordsmoen, Jan Ivar Røssberg, Bjørn Rishovd Rund, K Sundet, Per Vaglum, Svein Friis, Thomas McGlashan

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Abstract

    Objective: Early detection in first-episode psychosis confers advantages for negative, cognitive, and depressive symptoms after 1, 2, and 5 years, but longitudinal effects are unknown. The authors investigated the differences in symptoms and recovery after 10 years between regional health care sectors with and without a comprehensive program for the early detection of psychosis.

    Method: The authors evaluated 281 patients (early detection, N=141) 18 to 65 years old with a first episode of nonaffective psychosis between 1997 and 2001. Of these, 101 patients in the early-detection area and 73 patients in the usual-detection area were followed up at 10 years, and the authors compared their symptoms and recovery.

    Results: A significantly higher percentage of early-detection patients had recovered at the 10-year follow-up relative to usual-detection patients. This held true despite more severely ill patients dropping out of the study in the usual-detection area. Except for higher levels of excitative symptoms in the early-detection area, there were no symptom differences between the groups. Early-detection recovery rates were higher largely because of higher employment rates for patients in this group.

    Conclusions: Early detection of first-episode psychosis appears to increase the chances of milder deficits and superior functioning. The mechanisms by which this strategy improves the long-term prognosis of psychosis remain speculative. Nevertheless, our findings over 10 years may indicate that a prognostic link exists between the timing of intervention and outcome that deserves additional study.
    OriginalsprogEngelsk
    TidsskriftAmerican Journal of Psychiatry
    Vol/bind169
    Udgave nummer4
    Sider (fra-til)374-380
    ISSN0002-953X
    DOI
    StatusUdgivet - 2012

    Citer dette