Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study

Psychological Medicine - Tập 44 Số 13 - Trang 2713-2726 - 2014
Craig Morgan1,2, Julia Lappin3,2, Margaret Heslin4, Kim Donoghue5, Ben Lomas6, Ulrich Reininghaus1, Adanna Onyejiaka1, Tim Croudace7, Peter B. Jones8, Robin Murray3,2, Paul Fearon9, Gillian A. Doody6, Paola Dazzan3,2
1Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
2National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
3Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
4Centre for Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK
5Addictions Department, Institute of Psychiatry, King’s College London, UK
6Division of Psychiatry, University of Nottingham, UK
7Department of Health Sciences, University of York, UK
8Department of Psychiatry, University of Cambridge, UK
9Department of Psychiatry, Trinity College, Dublin, Ireland

Tóm tắt

BackgroundStudies of the long-term course and outcome of psychoses tend to focus on cohorts of prevalent cases. Such studies bias samples towards those with poor outcomes, which may distort our understanding of prognosis. Long-term follow-up studies of epidemiologically robust first-episode samples are rare.MethodAESOP-10 is a 10-year follow-up study of 557 individuals with a first episode of psychosis initially identified in two areas in the UK (South East London and Nottingham). Detailed information was collated on course and outcome in three domains (clinical, social and service use) from case records, informants and follow-up interviews.ResultsAt follow-up, of 532 incident cases identified, at baseline 37 (7%) had died, 29 (6%) had emigrated and eight (2%) were excluded. Of the remaining 458, 412 (90%) were traced and some information on follow-up was collated for 387 (85%). Most cases (265, 77%) experienced at least one period of sustained remission; at follow-up, 141 (46%) had been symptom free for at least 2 years. A majority (208, 72%) of cases had been employed for less than 25% of the follow-up period. The median number of hospital admissions, including at first presentation, was 2 [interquartile range (IQR) 1–4]; a majority (299, 88%) were admitted a least once and a minority (21, 6%) had 10 or more admissions. Overall, outcomes were worse for those with a non-affective diagnosis, for men and for those from South East London.ConclusionsSustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.

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Psychological Medicine

Tập 44 Số 13

2713-2726

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