Clinical and treatment predictors of relapse during a three-year follow-up of a cohort of first episodes of schizophrenia.
Por:
Bioque M, Mezquida G, Amoretti S, García-Rizo C, López-Ilundain JM, Diaz-Caneja CM, Zorrilla I, Mané A, Rodriguez-Jimenez R, Corripio I, Pomarol-Clotet E, Ibáñez Á, Usall J, Contreras F, Mas S, Vázquez-Bourgon J, Cuesta MJ, Parellada M, González-Pinto A, Hidalgo-Figueroa M, Bernardo M and 2EPs GROUP
Publicada:
1 may 2022
Ahead of Print:
26 feb 2022
Resumen:
Relapses are frequent in the first years following a first episode of schizophrenia (FES), being associated with a higher risk of developing a chronic psychotic disorder, and poor clinical and functional outcomes. The identification and intervention over factors associated with relapses in these early phases are timely and relevant. In this study, 119 patients in remission after a FES were closely followed over three years. Participants came from the 2EPS Project, a coordinated, naturalistic, longitudinal study of 15 tertiary centers in Spain. Sociodemographic, clinical, treatment and substance abuse data were analyzed. 49.6% of the participants relapsed during the 3-years follow-up. None of the baseline demographic and clinical characteristics analyzed showed a statistically significant association with relapses. 22% of patients that finished the follow-up without relapsing were not taking any antipsychotic. The group that relapsed presented higher mean antipsychotics doses (381.93 vs. 242.29 mg of chlorpromazine equivalent/day, p = 0.028) and higher rates of antipsychotic polytherapy (28.6% vs. 13%, p < 0.001), benzodiazepines use (30.8% vs. 8.5%, p < 0.001), side effects reports (39.2% vs. 25%, p = 0.022), psychological treatment (51.8% vs. 33.9%, p = 0.03), and cannabis consumption (93.2% vs. 56.7%, p < 0.001). Clozapine use was notably higher in the group that reminded in remission (21.7% vs. 8.2%, p < 0.019). These findings may guide clinicians to detect subgroups of patients with higher risk to present a second episode of psychosis, focusing on measures to ensure an adequate treatment or facilitating cannabis use cessation. This study supports future research to identify relapse prevention strategies for patients in early phases of schizophrenia.
Filiaciones:
Bioque M:
Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
Department of Medicine, University of Barcelona, Barcelona, Spain
Mezquida G:
Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
Amoretti S:
Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
Department of Psychiatry, Hospital Universitari Vall d'Hebron, Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Spain
Department of Medicine, University of Barcelona, Barcelona, Spain
Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
García-Rizo C:
Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
Department of Medicine, University of Barcelona, Barcelona, Spain
López-Ilundain JM:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
Navarra Health Research Institute (IdiSNA), Pamplona, Navarra, Spain
Diaz-Caneja CM:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
Zorrilla I:
Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Bioaraba, Spain
Mané A:
Hospital del Mar Medical Research Institute (IMIM), Spain
Universitat Autònoma de Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain
Rodriguez-Jimenez R:
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
Corripio I:
Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau, (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain
Universitat Autònoma de Barcelona (UAB), Spain
Pomarol-Clotet E:
FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
Ibáñez Á:
Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Madrid, Spain
Usall J:
Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain
Contreras F:
Psychiatric Unit, Bellvitge Universitary Hospital, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
IDIBELL, L'Hospitalet de Llobregat, Spain
Mas S:
Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Barcelona, Spain
Clinical and Experimental Neuroscience Area, The August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain
Vázquez-Bourgon J:
Department of Psychiatry, University Hospital Marqués de Valdecilla, Spain
Instituto de Investigación sanitaria Valdecilla (IDIVAL), Spain
University of Cantabria, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain
Cuesta MJ:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
Navarra Health Research Institute (IdiSNA), Pamplona, Navarra, Spain
Parellada M:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
González-Pinto A:
Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Bioaraba, Spain
Hidalgo-Figueroa M:
Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Spain
Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Spain
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Cádiz, Spain
Bernardo M:
Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
Department of Medicine, University of Barcelona, Barcelona, Spain
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