Clinical and treatment predictors of relapse during a three-year follow-up of a cohort of first episodes of schizophrenia
Por:
Bioque, M, Mezquida, G, Amoretti, S, Garcia-Rizo, C, Lopez-Ilundain, JM, Diaz-Caneja, CM, Zorrilla, I, Mane, A, Rodriguez-Jimenez, R, Corripio, I, Pomarol-Clotet, E, Ibanez, A, Usall, J, Contreras, F, Mas, S, Vazquez-Bourgon, J, Cuesta, MJ, Parellada, M, Gonzalez-Pinto, A, Hidalgo-Figueroa, M, Bernardo, M
Publicada:
1 may 2022
Ahead of Print:
1 feb 2022
Resumen:
Relapses are frequent in the first years following a first episode of schizophrenia (FES), being associated with a higher risk of developing a chronic psychotic disorder, and poor clinical and functional outcomes. The identification and intervention over factors associated with relapses in these early phases are timely and relevant.In this study, 119 patients in remission after a FES were closely followed over three years. Participants came from the 2EPS Project, a coordinated, naturalistic, longitudinal study of 15 tertiary centers in Spain. Sociodemographic, clinical, treatment and substance abuse data were analyzed.49.6% of the participants relapsed during the 3-years follow-up. None of the baseline demographic and clinical characteristics analyzed showed a statistically significant association with relapses. 22% of patients that finished the follow-up without relapsing were not taking any antipsychotic. The group that relapsed presented higher mean antipsychotics doses (381.93 vs. 242.29 mg of chlorpromazine equivalent/day, p = 0.028) and higher rates of antipsychotic polytherapy (28.6% vs. 13%, p < 0.001), benzodiazepines use (30.8% vs. 8.5%, p < 0.001), side effects reports (39.2% vs. 25%, p = 0.022), psychological treatment (51.8% vs. 33.9%, p = 0.03), and cannabis consumption (93.2% vs. 56.7%, p < 0.001). Clozapine use was notably higher in the group that reminded in remission (21.7% vs. 8.2%, p < 0.019). These findings may guide clinicians to detect subgroups of patients with higher risk to present a second episode of psychosis, focusing on measures to ensure an adequate treatment or facilitating cannabis use cessation. This study supports future research to identify relapse prevention strategies for patients in early phases of schizophrenia.
Filiaciones:
Bioque, M:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Mezquida, G:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Univ Barcelona, Dept Basic Clin Practice, Pharmacol Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Amoretti, S:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Hosp Univ Vall dHebron, Dept Psychiat, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Vall dHebron Res Inst VHIR, Psychiat Genet Unit, Grp Psychiat Mental Hlth & Addict, Barcelona, Spain
Garcia-Rizo, C:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Lopez-Ilundain, JM:
Complejo Hosp Navarra, Dept Psychiat, Navarra, Spain
Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain
Diaz-Caneja, CM:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth,Inst Invest Sanitaria, Dept Child & Adolescent Psychiat,Sch Med,CIBERSAM, Madrid, Spain
Zorrilla, I:
Univ Basque Country, Hosp Univ Araba, Serv Psiquiatria, Madrid, Spain
Navarra Hlth Res Inst IdiSNA, Navarra, Spain
Mane, A:
Hosp del Mar Med Res Inst IMIM, Madrid, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Bioaraba, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Barcelona, Spain
Rodriguez-Jimenez, R:
Inst Invest Sanitaria Hosp 12 Octubre Imas12, Madrid, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Barcelona, Spain
Corripio, I:
Hosp Santa Creu & Sant Pau, Inst Invest Biomed St Pau IIB St PAU, Psychiat Dept, Barcelona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Univ Complutense Madrid UCM, CogPsy Grp, Madrid, Spain
Pomarol-Clotet, E:
FIDMAG Germanes Hosp Res Fdn, Barcelona, Spain
Univ Autonoma Barcelona UAB, Barcelona, Spain
Ibanez, A:
Univ Alcala, Hosp Univ Ramon & Cajal, Dept Psychiat, IRYCIS, Alcala De Henares, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Usall, J:
Inst Recerca St Joan de Deu, Parc Sanitari St Joan de Deu, Teaching Res & Innovat Unit, St Boi De Llobregat, Spain
Contreras, F:
Bellvitge Univ Hosp, Psychiat Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Mas, S:
Univ Barcelona, Dept Basic Clin Practice, Pharmacol Unit, Barcelona, Spain
IDIBELL, Lhospitalet De Llobregat, Spain
Vazquez-Bourgon, J:
Univ Hosp Marques de Valdecilla, Dept Psychiat, Santander, Spain
August Pi & Sunyer Biomed Res Inst IDIBAPS, Clin & Expt Neurosci Area, Barcelona, Spain
Inst Invest Sanitaria Valdecilla IDIVAL, Madrid, Spain
Univ Cantabria, Santander, Spain
Cuesta, MJ:
Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain
Parellada, M:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth,Inst Invest Sanitaria, Dept Child & Adolescent Psychiat,Sch Med,CIBERSAM, Madrid, Spain
Gonzalez-Pinto, A:
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Inst Psychiat & Mental Hlth,Inst Invest Sanitaria, Dept Child & Adolescent Psychiat,Sch Med,CIBERSAM, Madrid, Spain
Navarra Hlth Res Inst IdiSNA, Navarra, Spain
Hidalgo-Figueroa, M:
Univ Cadiz, Dept Psychol, Neuropsychopharmacol & Psychobiol Res Grp, Cadiz, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Santander, Spain
Hosp Univ Puerta del Mar, Inst Invest & Innovac Biomed Cadiz, INiBICA, Cadiz, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM Cadiz, Cadiz, Spain
Bernardo, M:
Hosp Clin Barcelona, Neurosci Inst, Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain
Bronze, All Open Access; Bronze
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