Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Teaching, Research and Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jul;59(7):1255-1267. doi: 10.1007/s00127-023-02579-w. Epub 2023 Oct 20.
Recovery in people with first-episode psychosis (FEP) remains a major issue. When risk factors are studied in relation to the disorder, potential protective factors should also be considered since they can modulate this relationship. This study is aimed at exploring which premorbid and baseline characteristics are associated with a good and poor global recovery in patients with FEP at 3-year follow-up.
We categorized patients' outcome by using a Latent Class Analysis (LCA) considering a multimodal set of symptomatic and functional outcomes. A Mixed effects Models Repeated Measures analysis of variance (MMRM) was used to highlight group differences over time on symptomatic and functional outcomes assessed during the 3-year follow-up.
A total of 325 patients with FEP aged between 18 and 35 years were included. Two groups were identified. A total of 187 patients (57.5%) did not achieve recovery, and 138 patients (42.5%) achieved recovery. Recovered patients had generally a better premorbid and baseline profile in comparison with non-recovered patients (as among which shorter duration of untreated psychosis (DUP), higher degree of insight, better functional level and lower illness severity at baseline). The trajectories for the psychopathological and functional outcomes over 36 months differed between the non-recovered and the recovered group of patients.
Our results pointed to some variables associated with recovery, acting as potential protective factors. These should be considered for early intervention programs to promote psychological resilience specifically in those with a worse prognosis in order to mitigate the effects of the variables that make them more vulnerable to poorer outcome.
首发精神病（FEP）患者的康复仍然是一个主要问题。当研究与疾病相关的危险因素时，也应考虑潜在的保护因素，因为它们可以调节这种关系。本研究旨在探讨在 3 年随访时，哪些前驱期和基线特征与 FEP 患者的良好和不良整体康复相关。
我们通过使用潜在类别分析（LCA）对患者的结局进行分类，考虑了一系列症状和功能结局的多模态。使用混合效应模型重复测量方差分析（MMRM）来突出在 3 年随访期间评估的症状和功能结局随时间的组间差异。
共纳入了 325 名年龄在 18 至 35 岁之间的 FEP 患者。确定了两个组。共有 187 名患者（57.5%）未康复，138 名患者（42.5%）康复。与未康复患者相比，康复患者的前驱期和基线特征通常更好（如未治疗精神病期（DUP）较短、洞察力较高、功能水平较好且基线疾病严重程度较低）。在 36 个月内，精神病理学和功能结局的轨迹在未康复和康复患者组之间存在差异。
我们的结果指出了一些与康复相关的变量，它们是潜在的保护因素。这些应考虑纳入早期干预计划，以促进心理弹性，特别是针对那些预后较差的患者，以减轻使他们更容易出现不良结局的变量的影响。
