17-19 November 2014 - Tokyo, Japan - 9th International Conference on Early Psychosis - Oral Session 13 Wednesday, November 19, 12:45 - 2:10 pm, Takao
Psychopathology: Predictor, Course and Outcome
Chair: Eric Roche, DETECT Early Intervention in Psychosis Service, Blackrock, Co Dublin, Ireland
Co-Chair: Stephen F. Austin, University of Copenhagen, Denmark, Aarhus University, Denmark
Speakers: Martina Brandizzi
Predictors of six years functional remission in individuals at High Clinical Risk for Psychosis
Martina Brandizzi1,2,3, Lucia Valmaggia1,2, Majella Byrne1,2, Jones Ceri1, Nkechi Iwegbu2, Steven Badger2, Philip McGuire1,2, Paolo Fusar Poli1,2; 1King's College London, Institute of Psychiatry, London , United Kingdom;, 2OASIS team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom, 3Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant’Andrea Hospital, via di Grottarossa 1035, Rome, Italy
Objective: The long-term functional status of subjects at ultra high risk for psychosis (HR) is relatively under investigated. This study explores baseline predictors of long-term functional outcome in HR subjects who did not convert to psychosis during a 6 years follow-up period. Method: 154 HR patients were followed up for a mean time of 6 years. The primary outcome variable was global assessment of functioning at the last follow-up visit as assessed with the Global Assessment of Functioning tool. A multinomial logistic regression was performed to identify potential predictors of functional remission. Results: Baseline scores in the GAF (Exp(b)=0.857; 95% CIs: 0.75/0.97), employment status (Exp(b)=0.029; 95% CIs: 0.00/0.268), and CAARMS total scores (Exp(b)=1.976; 95% CIs: 1.00/1.14) predicted functional remission in HR subjects at 6 years. Conclusions: Despite the preventive treatments received, many individuals (n= 24; 43%) who did not convert to full-blown psychosis in the longer term do not functionally remit. These individuals are lower functioning, unemployed and have higher symptom loading at the time of their presentation to the prodromal clinic. Our study suggests the need for innovative treatments targeting long term functional status beyond the prevention of psychosis onset in the HR population.