Article

Stability and development of psychotic symptoms and the use of antipsychotic medication – long-term follow-up

Psychological Medicine, Cambridge University Press (CUP), ISSN 1469-8978

Volume 47, 12, 2017

DOI:10.1017/s0033291717000563, Dimensions: pub.1084536063, PMID: 28382874,

Affiliations

Organisations

  1. (1) Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
  2. (2) Lundbeck Foundation, grid.452548.a
  3. (3) Aarhus University Hospital, grid.154185.c, Central Denmark Region

Countries

Denmark

Continents

Europe

Description

BACKGROUND: Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis. METHOD: The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark. RESULTS: At all follow-ups, a large proportion (20-30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77-96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56-78%) probability of being in this group at the consecutive follow-up. CONCLUSIONS: A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.

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Aarhus University

Dimensions Citation Indicators

Times Cited: 8

Field Citation Ratio (FCR): 4.45

Relative Citation ratio (RCR): 1.09