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Psychosocial functioning in relation to symptomatic remission: A longitudinal study of first episode schizophrenia

Published online by Cambridge University Press:  05 October 2015

K. Jaracz ,
K. Górna ,
J. Kiejda ,
B. Grabowska-Fudala ,
J. Jaracz ,
A. Suwalska  and
J.K. Rybakowski
K. Jaracz*
Affiliation:
Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Smoluchowski 11 street, 60-179, Poznan, Poland
K. Górna
Affiliation:
Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Smoluchowski 11 street, 60-179, Poznan, Poland
J. Kiejda
Affiliation:
Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Smoluchowski 11 street, 60-179, Poznan, Poland
B. Grabowska-Fudala
Affiliation:
Department of Neurological and Psychiatric Nursing, Poznan University of Medical Sciences, Smoluchowski 11 street, 60-179, Poznan, Poland
J. Jaracz
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
A. Suwalska
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
J.K. Rybakowski
Affiliation:
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
*
⁎Corresponding author. Tel.: +048 61 6559 267; fax: +048 61 6559 266. E-mail address:jaracz@ump.edu.pl (K. Jaracz).
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Abstract

Objectives

The aims of the study were: (1) to evaluate longitudinally symptomatic remission in first-episode (FE) schizophrenia, (2) to describe symptoms, social functioning and quality of life (Qol) in relation to remission status, and (3) to determine the long-term outcome of schizophrenia and its early predictors.

Methods

Sixty-four patients were assessed 1 month after a first hospitalization (T1), 12 months (T2), 4–6 years (T3), and 7–11 years (T4) after T1. The patients were allocated to three remission groups according to their remission status over the whole observation period, e.g. stable remission (SR), unstable remission (UR) and non-remission (NR). The PANSS, Social Functioning Scale and WHOQoL were used to evaluate the patients’ psychosocial functioning levels, symptomatic and functional remissions and satisfying QoL. A good outcome was defined as meeting, simultaneously, the criteria of symptomatic and functional remissions and satisfying QoL at T4, while failure to meet all of these criteria was defined as a poor outcome.

Results

Among them, 17.2% patients were in stable remission, 57.8% in unstable remission and 25.0% were unremitted at all time points. The SR group had lower levels of psychopathological symptoms and reported better social functioning and QoL than the NR group. During the follow-up, the symptoms increased, social functioning slightly improved and QoL did not change. At T4, 53% of the sample had a poor outcome, which was independently predicted by the longer duration of untreated psychosis and a lack of satisfying QoL at T1.

Conclusions

Our results demonstrate that: (1) the long-term course in schizophrenia is heterogeneous and that three illness trajectories exist, (2) social functioning and QoL are only partially connected with symptomatic remission (3), the risk of a poor outcome may potentially be reduced by appropriate interventions at an early stage of the illness.

Keywords

SchizophreniaFirst episodeRemissionSocial functioningQuality of lifeLong-term study
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 907 - 913
Copyright
Copyright © European Psychiatric Association 2020

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