Abstract
Objective: Adolescent-onset psychosis has traditionally been characterized as a more severe form of psychosis with a poorer prognosis. However, it is still unclear if patients with an adolescent-onset have worse symptom remission outcomes. Symptom remission is the principal clinical outcome known to predict quality of life and social functioning in the long term. The goal of this study is to clarify the influence of age of onset of psychosis on symptom remission in a sample of first-episode psychosis patients. Method: A total of 246 first-episode psychosis patients were recruited from a specialized early intervention program serving a defined epidemiological catchment area. Age of onset of psychosis (adolescence vs. adulthood) was used as the main predictor, and duration of untreated psychosis (DUP), baseline symptoms, baseline functioning, substance abuse diagnosis, medication adherence and gender were used as covariates in hierarchical regression models predicting the following positive and negative symptom remission outcomes: maximum continuous months in remission and early remission (i.e., occurring in the first three months of follow-up). Results: After controlling for other variables, onset of psychosis in adulthood and shorter DUP predicted early remission of positive symptoms. This effect was stronger in patients with a diagnosis of a schizophrenia-spectrum disorder. Remission of negative symptoms did not depend on age of onset, and was only predicted by baseline negative symptoms. Conclusion: Patients with onset of psychosis during adulthood are more likely to achieve early positive symptom remission than those with adolescent onset. This effect might be stronger in patients with a diagnosis of a schizophrenia-spectrum disorder.
| Original language | English |
|---|---|
| Pages (from-to) | 183-188 |
| Number of pages | 6 |
| Journal | Schizophrenia Research |
| Volume | 174 |
| Issue number | 1-3 |
| DOIs | |
| Publication status | Published - 1 Jul 2016 |
Bibliographical note
Funding Information:Dr. Iyer is supported by the Fonds de recherche du Québec – Santé, and reports no biomedical financial interests or potential conflicts of interest.
Funding Information:
Dr. Malla is supported by the Canada Research Chairs Program funded by the Federal Government of Canada. In addition, Dr. Malla has received research funding and honoraria for conference presentations and participation in advisory boards for the following pharmaceutical industries in the past five years: Otsuka, Lundbeck, Roche, Janssen-Ortho, and Bristol-Myers Squibb.
Funding Information:
Dr. Joober is supported by the Fonds de recherche du Québec – Santé. In addition, Dr. Joober sits on the advisory boards and speakers’ bureaus of Pfizer Canada, Janssen Ortho Canada, BMS and Sunovian, Myelin Canada, Otsuka Canada and Perdue Pharmaceuticals; he has received grant funding from AstraZeneca and Lundbeck Canada. He has received honoraria from Janssen Ortho Canada, Shire and from Pfizer Canada for CME presentations and royalties from Henry Stewart talks.
Funding Information:
G Jordan MSc is a doctoral student under the supervision of Drs. Malla and Iyer, and funded through a scholarship from the Canadian Institutes of Health Research, and reports no biomedical financial interests or potential conflicts of interest.
Funding Information:
F. Veru MD MSc is a doctoral student under the supervision of Drs. Malla and Iyer. F. Veru and supported through a doctoral training award granted by the Fonds de recherche du Québec – Santé, and reports no biomedical financial interests or potential conflicts of interest.
Funding Information:
Dr. Iyer is supported by the Fonds de recherche du Québec – Santé.
Funding Information:
Dr. Malla is supported by the Canada Research Chairs Program funded by the Federal Government of Canada.
Funding Information:
Dr. Joober is supported by the Fonds de recherche du Québec – Santé.
Funding Information:
G Jordan MA is a doctoral student under the supervision of Drs. Malla and Iyer, and funded through a scholarship from the Canadian Institutes of Health Research
Funding Information:
F. Veru MD MSc is a doctoral student under the supervision of Drs. Malla and Iyer, and supported through a doctoral training award granted by the Fonds de recherche du Québec – Santé.
Funding Information:
The authors would like to express their gratitude to the participants and their families as well as the PEPP research staff. This research was supported by operating grants from CIHR (# 68961 ) and the Sackler Foundation to Drs. M. Lepage and A. Malla.
Publisher Copyright:
© 2016 Elsevier B.V.
Keywords
- Adolescence
- Age at onset
- First-episode-psychosis
- Multivariable regression
- Symptom remission
ASJC Scopus subject areas
- Psychiatry and Mental health
- Biological Psychiatry
