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Clinical illness course and family-related outcomes among parents with a first episode of schizophrenia spectrum disorder: a 20-year follow-up of the OPUS trial

Published online by Cambridge University Press:  02 April 2024

Helene Gjervig Hansen Open the ORCID record for Helene Gjervig Hansen [Opens in a new window] ,
Ida Christine Tholstrup Gjøde ,
Marie Starzer ,
Anne Ranning ,
Carsten Hjorthøj ,
Nikolai Albert ,
Merete Nordentoft  and
Anne Amalie Elgaard Thorup
Helene Gjervig Hansen*
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Ida Christine Tholstrup Gjøde
Affiliation:
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark The Research Unit – Child and Adolescent Mental Health Centre, The Capital Region, Copenhagen, Denmark
Marie Starzer
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Anne Ranning
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Carsten Hjorthøj
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
Nikolai Albert
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Mental Health Centre Amager, Copenhagen University Hospital, Digevej 110, 2300 Copenhagen, Denmark
Merete Nordentoft
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Anne Amalie Elgaard Thorup
Affiliation:
Copenhagen Research Centre for Mental Health – Core, Mental Health Center Copenhagen, Mental Health Services in the Capital Region, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark The Research Unit – Child and Adolescent Mental Health Centre, The Capital Region, Copenhagen, Denmark
*
Corresponding author: Helene Gjervig Hansen; Email: helene.gjervig.hansen@regionh.dk
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Abstract

Background

Studies investigating parenthood and how it affects long-term outcomes are lacking among individuals with schizophrenia spectrum disorders. This study aimed to examine the life of participants 20 years after their first diagnosis with a special focus on parenthood, clinical illness course, and family-related outcomes.

Methods

Among 578 individuals diagnosed with first-episode schizophrenia spectrum disorder between 1998 and 2000, a sample of 174 participants was reassessed at the 20-year follow-up. We compared symptom severity, remission, clinical recovery, and global functioning between 75 parents and 99 non-parents. Also, family functioning scored on the family assessment device, and the children's mental health was reported. We collected longitudinal data on psychiatric admission, supported housing, and work status via the Danish registers.

Results

Participants with offspring had significantly lower psychotic (mean (s.d.) of 0.89 (1.46) v. 1.37 (1.44), p = 0.031) negative (mean [s.d.] of 1.13 [1.16] v. 1.91 [1.07], p < 0.001) and disorganized symptom scores (mean [s.d.] of 0.46 [0.80] v. 0.85 [0.95], p = 0.005) and more were in remission (59.5% v. 22.4%, p < 0.001) and in clinical recovery (29.7% v. 11.1%, p = 0.002) compared to non-parents. When investigating global functioning over 20 years, individuals becoming parents after their first diagnosis scored higher than individuals becoming parents before their first diagnosis and non-parents. Regarding family-related outcomes, 28.6% reported unhealthy family functioning, and 10% of the children experienced daily life difficulties.

Conclusions

Overall, parents have more favorable long-term outcomes than non-parents. Still, parents experience possible challenges regarding family functioning, and a minority of their children face difficulties in daily life.

Keywords

familial-high-risk childrenfirst-episode schizophrenia spectrum disorderintergenerationallong-term outcomesparentpsychosisrecoveryrelapsesevere mental illness
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 10
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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