Dazzan Paola, Lappin Julia M, Heslin Margaret, Donoghue Kim, Lomas Ben, Reininghaus Uli, Onyejiaka Adanna, Croudace Tim, Jones Peter B, Murray Robin M, Fearon Paul, Doody Gillian A, Morgan Craig
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
National Institute for Health Research Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
Psychol Med. 2020 Jul;50(9):1452-1462. doi: 10.1017/S0033291719001399. Epub 2019 Jul 25.
To determine the baseline individual characteristics that predicted symptom recovery and functional recovery at 10-years following the first episode of psychosis.
AESOP-10 is a 10-year follow up of an epidemiological, naturalistic population-based cohort of individuals recruited at the time of their first episode of psychosis in two areas in the UK (South East London and Nottingham). Detailed information on demographic, clinical, and social factors was examined to identify which factors predicted symptom and functional remission and recovery over 10-year follow-up. The study included 557 individuals with a first episode psychosis. The main study outcomes were symptom recovery and functional recovery at 10-year follow-up.
At 10 years, 46.2% (n = 140 of 303) of patients achieved symptom recovery and 40.9% (n = 117) achieved functional recovery. The strongest predictor of symptom recovery at 10 years was symptom remission at 12 weeks (adj OR 4.47; CI 2.60-7.67); followed by a diagnosis of depression with psychotic symptoms (adj OR 2.68; CI 1.02-7.05). Symptom remission at 12 weeks was also a strong predictor of functional recovery at 10 years (adj OR 2.75; CI 1.23-6.11), together with being from Nottingham study centre (adj OR 3.23; CI 1.25-8.30) and having a diagnosis of mania (adj OR 8.17; CI 1.61-41.42).
Symptom remission at 12 weeks is an important predictor of both symptom and functional recovery at 10 years, with implications for illness management. The concepts of clinical and functional recovery overlap but should be considered separately.
确定首次精神病发作后10年预测症状恢复和功能恢复的基线个体特征。
AESOP - 10是一项对英国两个地区（伦敦东南部和诺丁汉）首次精神病发作时招募的基于人群的队列进行的10年随访研究。研究人员检查了有关人口统计学、临床和社会因素的详细信息，以确定哪些因素可预测10年随访期间的症状和功能缓解及恢复情况。该研究纳入了557例首次发作精神病的个体。主要研究结局为10年随访时的症状恢复和功能恢复。
10年后，46.2%（303例中的140例）的患者实现了症状恢复，40.9%（117例）实现了功能恢复。10年时症状恢复的最强预测因素是12周时的症状缓解（调整后比值比4.47；可信区间2.60 - 7.67）；其次是伴有精神病性症状的抑郁症诊断（调整后比值比2.68；可信区间1.02 - 7.05）。12周时的症状缓解也是10年时功能恢复的有力预测因素（调整后比值比2.75；可信区间1.23 - 6.11），同时还包括来自诺丁汉研究中心（调整后比值比3.23；可信区间1.25 - 8.30）以及患有躁狂症诊断（调整后比值比8.17；可信区间1.61 - 41.42）。
12周时的症状缓解是10年时症状和功能恢复的重要预测因素，对疾病管理具有重要意义。临床恢复和功能恢复的概念有重叠，但应分别予以考虑。
