TY - JOUR
T1 - The role of depression in the prediction of a "late" remission in first-episode psychosis
T2 - An analysis of the OPTiMiSE study
AU - Fraguas, David
AU - Díaz-Caneja, Covadonga M
AU - Pina-Camacho, Laura
AU - Winter van Rossum, Inge
AU - Baandrup, Lone
AU - Sommer, Iris E
AU - Glenthøj, Birte
AU - Kahn, René S
AU - Leucht, Stefan
AU - Arango, Celso
N1 - Copyright © 2021. Published by Elsevier B.V.
PY - 2021/5
Y1 - 2021/5
N2 - OBJECTIVE: The identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES).METHODS: We analyzed two non-independent subsamples of patients with FES ages 18-40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate "late" remitters (i.e., not in remission at week 2 or 4, but achieving remission within a 10-week follow-up period) from non-remitters within the same period.RESULTS: Subsample 1 included 216 individuals (55 females, mean age 25.9 years) treated with amisulpride in an open-label design who were not in remission at week 2. Early symptomatic response between baseline and week 2 (odds ratio (OR) = 4.186, 95% confidence interval (CI) = 2.082-8.416, p < 0.001) and older age (OR = 1.081, 95% CI = 1.026-1.138, p = 0.003) were the only variables significantly associated with a higher probability of psychosis remission at week 4. Subsample 2 was composed of the 72 participants (19 females, mean age 25.1 years) who were not in remission at week 4 and completed a 6-week double-blind randomized trial comparing continuation of amisulpride with switch to olanzapine. Depression at baseline (as measured with the Calgary Depression Scale for Schizophrenia) was significantly associated with a nearly 3-fold lower likelihood of psychosis remission during the 10-week follow-up (hazard ratio = 2.865, 95% CI = 1.187-6.916, p = 0.019).CONCLUSION: Our results reinforce the importance of assessing depressive symptoms in people with FES and support the relevance of an early response (as early as 2 weeks) as a predictor of clinical outcome in this population.CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier: NCT01248195, https://clinicaltrials.gov/ct2/show/NCT01248195.
AB - OBJECTIVE: The identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES).METHODS: We analyzed two non-independent subsamples of patients with FES ages 18-40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate "late" remitters (i.e., not in remission at week 2 or 4, but achieving remission within a 10-week follow-up period) from non-remitters within the same period.RESULTS: Subsample 1 included 216 individuals (55 females, mean age 25.9 years) treated with amisulpride in an open-label design who were not in remission at week 2. Early symptomatic response between baseline and week 2 (odds ratio (OR) = 4.186, 95% confidence interval (CI) = 2.082-8.416, p < 0.001) and older age (OR = 1.081, 95% CI = 1.026-1.138, p = 0.003) were the only variables significantly associated with a higher probability of psychosis remission at week 4. Subsample 2 was composed of the 72 participants (19 females, mean age 25.1 years) who were not in remission at week 4 and completed a 6-week double-blind randomized trial comparing continuation of amisulpride with switch to olanzapine. Depression at baseline (as measured with the Calgary Depression Scale for Schizophrenia) was significantly associated with a nearly 3-fold lower likelihood of psychosis remission during the 10-week follow-up (hazard ratio = 2.865, 95% CI = 1.187-6.916, p = 0.019).CONCLUSION: Our results reinforce the importance of assessing depressive symptoms in people with FES and support the relevance of an early response (as early as 2 weeks) as a predictor of clinical outcome in this population.CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov identifier: NCT01248195, https://clinicaltrials.gov/ct2/show/NCT01248195.
KW - Adolescent
KW - Adult
KW - Antipsychotic Agents/therapeutic use
KW - Depression/drug therapy
KW - Female
KW - Humans
KW - Male
KW - Olanzapine/therapeutic use
KW - Psychotic Disorders/drug therapy
KW - Schizophrenia/drug therapy
KW - Treatment Outcome
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85103937241&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2021.03.010
DO - 10.1016/j.schres.2021.03.010
M3 - Journal article
C2 - 33838518
SN - 0920-9964
VL - 231
SP - 100
EP - 107
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -