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

Raimo K R Salokangas,Sinikka Luutonen,Reetta-Liina Armio,Heikki Laurikainen,Maija Walta,Tuula Ilonen,Lauri Tuominen,Anna Toivonen,Päivi Jalo,Tiina From,Jarmo Hietala,Janina Paju,Markus Heinimaa

doi:10.1186/s12888-021-03516-4

Raimo K R Salokangas, Sinikka Luutonen + Show 11 more

Open Access

https://doi.org/10.1186/s12888-021-03516-4

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Abstract

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.

Highlights

Functional recovery of patients with clinical and subclinical psychosis is associated with clinical, neuropsychological and developmental factors
Baseline sociodemographic and clinical characteristics In terms of sociodemographic factors and social support received, no differences were observed between patients with first-episode psychosis (FEP), CHR-P and CHR-N
SIPS psychotic symptoms, which were used as diagnostic criteria for FEP, CHR-P and CHR-N, increased linearly from CHR-N to CHR-P (p < 0.001) and from CHR-P to FEP (p < 0.001)

Summary

Introduction

Functional 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). Clarification of the factors affecting outcomes in patients with psychoses is of great importance. Compared to other psychotic disorders, schizophrenia is consistently characterized by poorer courses and outcomes [8]. During a long-term follow-up of patients with schizophrenia, baseline neurocognitive impairments did not correlate with the clinical outcome [29]. Less is known about their role in predicting the functional outcomes of patients with psychosis

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