Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-45s75 Total loading time: 0.16 Render date: 2021-12-05T15:11:59.480Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Article contents

Development and validation of a non-remission risk prediction model in First Episode Psychosis: An analysis of two longitudinal studies

Published online by Cambridge University Press:  18 June 2021

Samuel Leighton*
Affiliation:
University of Glasgow
Pavan Mallikarjun
Affiliation:
University of Birmingham
Rajeev Krishnadas
Affiliation:
NHS Greater Glasgow & Clyde
Jonathan Cavanagh
Affiliation:
University of Glasgow
Simon Rogers
Affiliation:
University of Glasgow
Rachel Upthegrove
Affiliation:
University of Birmingham
Max Birchwood
Affiliation:
University of Warwick
Stephen Marwaha
Affiliation:
University of Birmingham
Ewout Steyerberg
Affiliation:
University of Leiden
Georgios Gkoutos
Affiliation:
University of Birmingham
Matthew Broome
Affiliation:
University of Birmingham
Peter Liddle
Affiliation:
University of Nottingham
Linda Everard
Affiliation:
Neuropsychiatry - The Barberry Center
Swaran Singh
Affiliation:
University of Warwick
Nicholas Freemantle
Affiliation:
University College London
David Fowler
Affiliation:
University of Sussex
Peter Jones
Affiliation:
University of Cambridge
Vimal Sharma
Affiliation:
University of Chester
Robin Murray
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London
Til Wykes
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London
Richard Drake
Affiliation:
University of Manchester
Iain Buchan
Affiliation:
University of Liverpool
Shon Lewis
Affiliation:
University of Manchester
*
*corresponding author.
Rights & Permissions[Opens in a new window]

Abstract

HTML view is not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims

Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom non-remission in first-episode psychosis.

Method

Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 to 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 to 2009 from a further 11 English early intervention services. The one-year non-remission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for non-remission, which was externally validated.

Result

The prediction model showed good discrimination (C-statistic of 0.74 (0.72, 0.76) and adequate calibration with intercept alpha of 0.13 (0.03, 0.23) and slope beta of 0.99 (0.87, 1.12). Our model improved the net-benefit by 16% at a risk threshold of 50%, equivalent to 16 more detected non-remitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases.

Conclusion

Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of non-remission at initial clinical contact.

Type
Rapid-Fire Poster Presentations
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists
Submit a response

eLetters

No eLetters have been published for this article.
You have Access
Open access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Development and validation of a non-remission risk prediction model in First Episode Psychosis: An analysis of two longitudinal studies
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Development and validation of a non-remission risk prediction model in First Episode Psychosis: An analysis of two longitudinal studies
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Development and validation of a non-remission risk prediction model in First Episode Psychosis: An analysis of two longitudinal studies
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *