The role of depression in the prediction of a "late" remission in first-episode psychosis: An analysis of the OPTiMiSE study

David Fraguas, Covadonga M Díaz-Caneja, Laura Pina-Camacho, Inge Winter van Rossum, Lone Baandrup, Iris E Sommer, Birte Glenthøj, René S Kahn, Stefan Leucht, Celso Arango

4 Citationer (Scopus)

Abstract

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.

OriginalsprogEngelsk
TidsskriftSchizophrenia Research
Vol/bind231
Sider (fra-til)100-107
Antal sider8
ISSN0920-9964
DOI
StatusUdgivet - maj 2021

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