Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Universitat Rovira i Virgili, Tarragona, Spain.
University of Oviedo, Oviedo, Spain.
Clin Psychol Rev. 2017 Dec;58:59-75. doi: 10.1016/j.cpr.2017.09.007. Epub 2017 Oct 6.
Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes.
To systematically compile and analyse predictors of functional recovery in FEP.
Systematic review and meta-analysis of peer-reviewed, longitudinal studies reporting predictors of functioning, with a minimum 12-month follow-up and at least 80% of participants diagnosed with FEP.
Out of 2205 citations, 274 articles were retrieved for detailed evaluation resulting in 50 eligible studies (N=6669). Sociodemographic, clinical, physical and neuroimaging variables had little impact on long-term functioning. Conversely duration of untreated psychosis (DUP), most cognitive variables, and concurrent remission of positive and negative symptoms were independently related to functional recovery.
These findings strongly support the rationale for early intervention in FEP. Novel treatments targeting cognitive deficits may improve functional outcomes in FEP.
四分之三的首发精神病（FEP）患者在治疗后达到临床缓解。不幸的是，功能恢复落后于症状缓解，许多 FEP 患者仍然社会隔离，功能结局较差。
系统地编制和分析 FEP 功能恢复的预测因素。
对同行评审的、纵向研究进行系统回顾和荟萃分析，这些研究报告了功能的预测因素，随访时间至少为 12 个月，且至少 80%的参与者被诊断为 FEP。
在 2205 条引文中，有 274 篇文章进行了详细评估，最终有 50 项符合条件的研究（N=6669）入选。社会人口统计学、临床、身体和神经影像学变量对长期功能的影响很小。相反，未治疗精神病持续时间（DUP）、大多数认知变量以及阳性和阴性症状的同时缓解与功能恢复独立相关。
这些发现强烈支持了在 FEP 中进行早期干预的基本原理。针对认知缺陷的新疗法可能会改善 FEP 的功能结局。
