Ten-Year Outcomes of First-Episode Psychoses in the MRC ÆSOP-10 Study.

Camice J Revier Ulrich Reininghaus Rina Dutta Paul Fearon Robin M Murray Gillian A Doody Tim Croudace Paola Dazzan Margaret Heslin Adanna Onyejiaka Eugenia Kravariti Julia Lappin Ben Lomas James B Kirkbride Kim Donoghue Craig Morgan Peter B Jones

J Nerv Ment Dis

*Department of Psychiatry, University of Cambridge, National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and NIHR Collaboration for Leadership in Applied Health Research & Care, Cambridge, UK; †Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK; ‡Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; §Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK; ∥Department of Psychiatry, Trinity College, Dublin, Ireland; ¶NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK; #Psychosis Studies Department, Institute of Psychiatry, King's College, London, UK; **Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK; ††Department of Nursing and Midwifery, University of Dundee, Dundee, UK; ‡‡Centre for Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK; §§Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience at King's College, London, UK; ∥∥Institute of Psychiatry, Psychology & Neuroscience at King's College, London, UK; ¶¶Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia; ##Division of Psychiatry, University College London, London, UK; and ***Addictions Department, Institute of Psychiatry, King's College, London, UK.

Published: May 2015

Schizophrenia and psychotic disorders typically have a poor reputation for long-term outcomes, but new findings indicate that symptomatic remission and recovery may be more common than previously thought.
Distinctly separating symptom recovery from social recovery is crucial since individuals may experience symptom relief without achieving social inclusion.
Family involvement during the initial contact significantly decreases the risk of unnatural death, suggesting the importance of support systems in improving outcomes for people with first-episode psychosis.

It has long been held that schizophrenia and other psychotic disorders have a predominately poor course and outcome. We have synthesized information on mortality, clinical and social outcomes from the ÆSOP-10 multicenter study, a 10-year follow-up of a large epidemiologically characterized cohort of 557 people with first-episode psychosis. Symptomatic remission and recovery were more common than previously believed. Distinguishing between symptom and social recovery is important given the disparity between these; even when symptomatic recovery occurs social inclusion may remain elusive. Multiple factors were associated with an increased risk of mortality, but unnatural death was reduced by 90% when there was full family involvement at first contact compared with those without family involvement. These results suggest that researchers, clinicians and those affected by psychosis should countenance a much more optimistic view of symptomatic outcome than was assumed when these conditions were first described.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414339	PMC
http://dx.doi.org/10.1097/NMD.0000000000000295	DOI Listing

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