Stability of schizophrenia diagnosis in a 10-year longitudinal study on first episode of non-affective psychosis: Conclusions from the PAFIP cohort.
Suárez-Pinilla P; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Suárez-Pinilla M; Department of Neurodegenerative Disease, Institute of Neurology, University College of London, London, UK.
Setién-Suero E; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Ortiz-García de la Foz V; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Mayoral-Van Son J; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocío - IBiS, Sevilla, Spain.
Vázquez-Bourgon J; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Gómez-Revuelta M; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.
Juncal-Ruíz M; Department of Psychiatry, IDIVAL, School of Medicine, Sierrallana Hospital, University of Cantabria, Torrelavega, Spain.
Ayesa-Arriola R; Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain.; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
Crespo-Facorro B; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.; Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocío - IBiS, Sevilla, Spain.
Acta psychiatrica Scandinavica [Acta Psychiatr Scand] 2021 Oct; Vol. 144 (4), pp. 342-357. Date of Electronic Publication: 2021 Jul 21.
Publication Type :
Imprint Name(s) :
Publication: Malden, MA : Wiley-Blackwell
Original Publication: Copenhagen : Munksgaard International Publishers
MeSH Terms :
Child ; Humans ; Longitudinal Studies ; Male ; Prospective Studies ; Retrospective Studies
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Contributed Indexing :
Keywords: cohort*; diagnosis*; first-episode psychosis*; follow-up*; schizophrenia*
Entry Date(s) :
Date Created: 20210706 Date Completed: 20210922 Latest Revision: 20210922
Update Code :
Objective: To evaluate the 10-year stability of schizophrenia diagnosis in a cohort of first-episode psychosis (FEP) patients and the factors associated with it.
Methods: Changes in diagnosis of 209 FEP patients were described during 10 years of follow-up. Related factors with maintenance or change of schizophrenia diagnosis were evaluated in prospective and retrospective approaches through binary logistic regressions, ROC and survival curves.
Results: Out of the 209 patients, 126 were diagnosed of schizophrenia 6 months after their inclusion in the clinical program. Prospective analyses showed that eight of those 126 schizophrenia patients had changed to a different diagnosis after 10 years, and predictors of change were better childhood premorbid adjustment, less severity of clinical global impression at baseline, and diagnosis of comorbid personality disorder during follow-up. Retrospectively, out of the 154 patients with schizophrenia in the 10-year assessment, 36 had a different diagnosis at baseline, and those factors related to a different prior diagnosis than schizophrenia were better socioeconomic status and shorter duration of untreated psychosis (DUP). A survival analysis on the timing of schizophrenia diagnosis showed that male gender and longer DUP were predictors of earlier definite diagnosis.
Conclusions: Diagnostic stability of schizophrenia in our FEP sample is high, especially prospective stability, and the group of patients with diagnostic change corresponded to a milder psychopathological profile before and at the onset of disease. Moreover, we observed a cautious attitude in the diagnosis of schizophrenia in patients with shorter DUP who had schizophrenia diagnosis after 10 years.
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