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Remission or recovery common after a first episode of psychosis
Clinical Question
In people treated for a first episode of psychosis, what is the likelihood of a second episode?
Bottom line
Good news for patients with a first episode of psychosis: More than half will achieve a symptomatic and/or functional improvement that is sustained over at least several years. Recovery—the absence of symptoms—will occur in approximately one third of all patients and in 85% of patients with affective psychosis. 2a
Reference
Study design: Cohort (prospective)
Funding: Unknown/not stated
Setting: Various (meta-analysis)
Synopsis
The authors of this meta-analysis searched the National Library of Medicine database and Scopus to identify 79 published studies enrolling a total of 19,072 patients older than 16 years who were treated for a first psychotic episode and were followed up for at least 12 months. Two authors completed the search and extracted the data from both prospective and retrospective cohort studies. More than half of the patients (57.9%) achieved remission, meaning symptomatic and/or functional improvement, in studies with an average follow-up of 5.5 years (95% CI 52.68% - 62.93%). Remission rates were higher in Africa, Asia, and North America than in other areas of the world. Recovery—the absence of symptoms—occurred in 37.9% of patients (30.03% - 46.45%) and was more likely to be reported in North America. Recovery rates were similar in patients with a first episode of psychosis or schizophrenia, and patients with affective psychosis had a very high recovery rate (84.6%). There was no evidence of publication bias.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Not directly relevant but patients with psychosis is present in all patients population and is important to suspect and refer for proper rx , this study shows %%0 recovery that is new for me but most patient can be controlled and achieve normal function including ability to deal with chronic pain.
Not enough information provided. What was the incidence of recreational drug use in this population? What degree of improvement constitutes remission? With these outcomes with medical or other therapy?
Good poem
I would have liked to know if they are talking of recovery/remission while on medication or that they do not require medication long term
Excellent