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Psychosocial outcome in patients at clinical high risk of psychosis: a prospective follow-up |
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| Authors: | Raimo K R Salokangas Dorien H Nieman Markus Heinimaa Tanja Svirskis Sinikka Luutonen Tiina From Heinrich Graf von Reventlow Georg Juckel Don Linszen Peter Dingemans Max Birchwood Paul Patterson Frauke Schultze-Lutter Joachim Klosterkötter Stephan Ruhrmann |
| Institution: | 1. Department of Psychiatry, University of Turku, 20520, Turku, Finland 2. Psychiatric Clinic, Turku University Central Hospital, Turku, Finland 3. Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland 4. Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands 5. Department of Psychiatry, University of Helsinki, Helsinki, Finland 6. Peijas Hospital, Helsinki University Central Hospital, Helsinki, Finland 7. Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany 8. Department of Psychiatry and Psychology, University of Maastricht, Maastricht, Netherlands 10. Mediant, Enschede, Netherlands 9. Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands 11. School of Psychology, University of Birmingham, Birmingham, UK 12. Youthspace, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK 13. University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland 14. Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany |
| Abstract: | PurposeIn patients at clinical high risk (CHR) of psychosis, transition to psychosis has been the focus of recent studies. Their broader outcome has received less attention. We studied psychosocial state and outcome in CHR patients.MethodsIn the European Prediction of Psychosis Study, 244 young help-seeking CHR patients were assessed with the Strauss and Carpenter Prognostic Scale (SCPS) at baseline, and 149 (61.1 %) of them were assessed for the second time at the 18-month follow-up. The followed patients were classified into poor and good outcome groups.ResultsFemale gender, ever-married/cohabitating relationship, and good working/studying situation were associated with good baseline SCPS scores. During follow-up, patients’ SCPS scores improved significantly. Good follow-up SCPS scores were predicted by higher level of education, good working/studying status at baseline, and white ethnicity. One-third of the followed CHR patients had poor global outcome. Poor working/studying situation and lower level of education were associated with poor global outcome. Transition to psychosis was associated with baseline, but not with follow-up SCPS scores or with global outcome.ConclusionThe majority of CHR patients experience good short-term recovery, but one-third have poor psychosocial outcome. Good working situation is the major indicator of good outcome, while low level of education and non-white ethnicity seem to be associated with poor outcome. Transition to psychosis has little effect on psychosocial outcome in CHR patients. In treating CHR patients, clinicians should focus their attention on a broader outcome, and not only on preventing transition to psychosis. |
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