Olga Santesteban-Echarri1, Mercedes Paino2, Simon Rice3, César González-Blanch4, Patrick McGorry5, John Gleeson6, Mario Alvarez-Jimenez7. 1. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Universitat Rovira i Virgili, Tarragona, Spain. Electronic address: olga.santesteban@gmail.com. 2. University of Oviedo, Oviedo, Spain. Electronic address: mpaino@uniovi.es. 3. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: simon.rice@orygen.org.au. 4. University Hospital Marques de Valdecilla-IDIVAL, Santander, Spain. Electronic address: cesar.gonzalezblanch@scsalud.es. 5. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: pat.mcgorry@orygen.org. 6. School of Psychology, Australian Catholic University, Melbourne, Australia. Electronic address: John.Gleeson@acu.edu.au. 7. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: Mario.Alvarez@orygen.org.au.
Abstract
BACKGROUND: Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes. AIMS: To systematically compile and analyse predictors of functional recovery in FEP. METHOD: Systematic review and meta-analysis of peer-reviewed, longitudinal studies reporting predictors of functioning, with a minimum 12-month follow-up and at least 80% of participants diagnosed with FEP. RESULTS: Out of 2205 citations, 274 articles were retrieved for detailed evaluation resulting in 50 eligible studies (N=6669). Sociodemographic, clinical, physical and neuroimaging variables had little impact on long-term functioning. Conversely duration of untreated psychosis (DUP), most cognitive variables, and concurrent remission of positive and negative symptoms were independently related to functional recovery. CONCLUSIONS: These findings strongly support the rationale for early intervention in FEP. Novel treatments targeting cognitive deficits may improve functional outcomes in FEP.
BACKGROUND: Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes. AIMS: To systematically compile and analyse predictors of functional recovery in FEP. METHOD: Systematic review and meta-analysis of peer-reviewed, longitudinal studies reporting predictors of functioning, with a minimum 12-month follow-up and at least 80% of participants diagnosed with FEP. RESULTS: Out of 2205 citations, 274 articles were retrieved for detailed evaluation resulting in 50 eligible studies (N=6669). Sociodemographic, clinical, physical and neuroimaging variables had little impact on long-term functioning. Conversely duration of untreated psychosis (DUP), most cognitive variables, and concurrent remission of positive and negative symptoms were independently related to functional recovery. CONCLUSIONS: These findings strongly support the rationale for early intervention in FEP. Novel treatments targeting cognitive deficits may improve functional outcomes in FEP.
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