OBJECTIVE: We aimed to develop and establish the reliability and validity of a measure of Fear of Recurrence, measuring cognitive appraisals of relapse rather than standard early signs of relapse. We also aimed to establish the sensitivity and specificity to relapse. METHOD:Participants diagnosed with schizophrenia or a related disorder were randomized to one of two early signs monitoring conditions, using either the Early Signs Scale or the Fear of Recurrence Scale (FoRSe). Participants were followed up for 6-months or until relapse. RESULTS: A total of 169 participants were randomized to Standard (n = 86) orFoRSe (n = 83) monitoring. We found good evidence supporting reliability and validity of the FoRSe. In addition, a cut-off point of ≥ 5 was associated with an optimal sensitivity in both Standard (n = 26:79%, 95% CI = 62-89) and FoRSe (n = 18:72%, 95% CI = 52-86) monitoring. However, this degree of sensitivity was associated with a lower specificity in Standard (n = 30:35%, 96% CI = 23-50) and FoRSe (n = 25:46%, 95% CI = 32-60). Finally, Fear of Relapse was a significant predictor of time to relapse [Exp(β) = 1.20, 95% CI = 1.01-1.42, p < .05]. CONCLUSION: The study provides evidence that Fear of Recurrence may be an important clinical construct linked to increased risk of relapse and poorer emotional recovery in people diagnosed with schizophrenia. PRACTITIONER POINTS: Monitoring Fear of Recurrence is as sensitive to relapse detection as monitoring early signs alone. Greater Fear of Relapse was associated with shorter duration to actual relapse. Fear of recurrence may be an important clinical feature linked to poorer emotional recovery and increased risk of relapse. Fear of Recurrence may be an important focus of psychological therapy to promote emotional recovery and prevention of relapse.
RCT Entities:
OBJECTIVE: We aimed to develop and establish the reliability and validity of a measure of Fear of Recurrence, measuring cognitive appraisals of relapse rather than standard early signs of relapse. We also aimed to establish the sensitivity and specificity to relapse. METHOD:Participants diagnosed with schizophrenia or a related disorder were randomized to one of two early signs monitoring conditions, using either the Early Signs Scale or the Fear of Recurrence Scale (FoRSe). Participants were followed up for 6-months or until relapse. RESULTS: A total of 169 participants were randomized to Standard (n = 86) or FoRSe (n = 83) monitoring. We found good evidence supporting reliability and validity of the FoRSe. In addition, a cut-off point of ≥ 5 was associated with an optimal sensitivity in both Standard (n = 26:79%, 95% CI = 62-89) and FoRSe (n = 18:72%, 95% CI = 52-86) monitoring. However, this degree of sensitivity was associated with a lower specificity in Standard (n = 30:35%, 96% CI = 23-50) and FoRSe (n = 25:46%, 95% CI = 32-60). Finally, Fear of Relapse was a significant predictor of time to relapse [Exp(β) = 1.20, 95% CI = 1.01-1.42, p < .05]. CONCLUSION: The study provides evidence that Fear of Recurrence may be an important clinical construct linked to increased risk of relapse and poorer emotional recovery in people diagnosed with schizophrenia. PRACTITIONER POINTS: Monitoring Fear of Recurrence is as sensitive to relapse detection as monitoring early signs alone. Greater Fear of Relapse was associated with shorter duration to actual relapse. Fear of recurrence may be an important clinical feature linked to poorer emotional recovery and increased risk of relapse. Fear of Recurrence may be an important focus of psychological therapy to promote emotional recovery and prevention of relapse.
Authors: Andrew I Gumley; Simon Bradstreet; John Ainsworth; Stephanie Allan; Mario Alvarez-Jimenez; Maximillian Birchwood; Andrew Briggs; Sandra Bucci; Sue Cotton; Lidia Engel; Paul French; Reeva Lederman; Shôn Lewis; Matthew Machin; Graeme MacLennan; Hamish McLeod; Nicola McMeekin; Cathy Mihalopoulos; Emma Morton; John Norrie; Frank Reilly; Matthias Schwannauer; Swaran P Singh; Suresh Sundram; Andrew Thompson; Chris Williams; Alison Yung; Lorna Aucott; John Farhall; John Gleeson Journal: Health Technol Assess Date: 2022-05 Impact factor: 4.106
Authors: Andrew Gumley; Simon Bradstreet; John Ainsworth; Stephanie Allan; Mario Alvarez-Jimenez; Louise Beattie; Imogen Bell; Max Birchwood; Andrew Briggs; Sandra Bucci; Emily Castagnini; Andrea Clark; Sue M Cotton; Lidia Engel; Paul French; Reeva Lederman; Shon Lewis; Matthew Machin; Graeme MacLennan; Claire Matrunola; Hamish McLeod; Nicola McMeekin; Cathrine Mihalopoulos; Emma Morton; John Norrie; Frank Reilly; Matthias Schwannauer; Swaran P Singh; Lesley Smith; Suresh Sundram; David Thomson; Andrew Thompson; Helen Whitehill; Alison Wilson-Kay; Christopher Williams; Alison Yung; John Farhall; John Gleeson Journal: JMIR Res Protoc Date: 2020-01-09
Authors: Daniel Freeman; Anthony Morrison; Jessica C Bird; Eleanor Chadwick; Emily Bold; Kathryn M Taylor; Rowan Diamond; Nicola Collett; Emma Černis; Louise Isham; Rachel Lister; Miriam Kirkham; Ashley-Louise Teale; Eve Twivy; Felicity Waite Journal: BJPsych Open Date: 2019-09-17
Authors: Stephanie Allan; Simon Bradstreet; Hamish J McLeod; John Gleeson; John Farhall; Maria Lambrou; Andrea Clark; Andrew I Gumley Journal: BJPsych Open Date: 2019-12-12
Authors: Stephanie Allan; Simon Bradstreet; Hamish Mcleod; John Farhall; Maria Lambrou; John Gleeson; Andrea Clark; Andrew Gumley Journal: J Med Internet Res Date: 2019-10-24 Impact factor: 5.428
Authors: Stephanie Allan; Hamish Mcleod; Simon Bradstreet; Sara Beedie; Bethany Moir; John Gleeson; John Farhall; Emma Morton; Andrew Gumley Journal: JMIR Res Protoc Date: 2019-12-10