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Stability and development of psychotic symptoms and the use of antipsychotic medication – long-term follow-up

Published online by Cambridge University Press:  06 April 2017

D. R. Gotfredsen ,
R. S. Wils ,
C. Hjorthøj ,
S. F. Austin ,
N. Albert ,
R. G. Secher ,
A. A. E. Thorup ,
O. Mors  and
M. Nordentoft
D. R. Gotfredsen*
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
R. S. Wils
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
C. Hjorthøj
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
S. F. Austin
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
N. Albert
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
R. G. Secher
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
A. A. E. Thorup
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
O. Mors
Affiliation:
The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
M. Nordentoft
Affiliation:
Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
*
*Address for correspondence: D. R. Gotfredsen, M.D., Mental Health Centre Copenhagen, Kildegårdsvej 28, opg. 15, 2900 Hellerup, Denmark. (Email: [email protected])
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Abstract

Background

Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis.

Method

The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark.

Results

At all follow-ups, a large proportion (20–30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77–96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56–78%) probability of being in this group at the consecutive follow-up.

Conclusions

A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.

Keywords

Schizophreniapsychotic illnessmedicationlong-term outcome.
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 12 , September 2017 , pp. 2118 - 2129
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

These authors contributed equally to this work.

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