First-Episode Psychosis: Diagnostic Stability over One and Two YearsHaahr U. · Friis S. · Larsen T.K. · Melle I. · Johannessen J.O. · Opjordsmoen S. · Simonsen E. · Rund B.R. · Vaglum P. · McGlashan T.
aPsychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark; bUllevaal University Hospital and Departments of cPsychiatry, dPsychology, and eBehavioral Sciences in Medicine, University of Oslo, Oslo, fStavanger University Hospital, Haugesund Hospital, Stavanger, Norway; gDepartment of Psychiatry, Yale University, New Haven, Conn., USA
Background: Diagnostic stability is important for daily clinical work and planning of treatment. The aims of this study were to measure diagnostic stability in a clinical epidemiologic sample and to identify markers of change in diagnosis. Sampling and Methods: Diagnostic stability and change were measured in a sample of 301 patients with first-episode psychosis from four national health care sectors in Norway and Denmark at baseline, 1 and 2 years. Results: Diagnostic stabilities were high for schizophrenia and schizoaffective disorder (85–99%), low for schizophreniform disorder (16–19%), and intermediate for other diagnoses. Diagnostic change from schizophreniform to schizophrenia was frequent in year 1 (72%). Characteristics discriminating schizophreniform patients keeping their diagnosis (i.e. having recovered within 6 months with no relapse) from those developing schizophrenia at 1 year were female gender, better childhood premorbid functioning, shorter duration of untreated psychosis and more severe general psychotic symptoms, especially excitation. Conclusions: Findings provide validation for the DSM-IV categories within the schizophrenic spectrum. The limitations of the study were: the raters were not blind to baseline assessments; patients with longer duration of untreated psychosis were more likely to refuse participation; not all patients were assessed at 1- and 2-year follow-up, but the attrition was rather low.
Ulrik Haahr, MD
Psychiatric Research Unit, Zealand Region Psychiatry Roskilde
DK–4000 Roskilde (Denmark)
Tel. +45 47 32 77 75, Fax +45 46 37 21 53, E-Mail firstname.lastname@example.org
This paper is part of the TIPS project with the following research group: Thomas McGlashan (PI), Per Vaglum (PI), Svein Friis, Ulrik Haahr, Jan Olav Johannessen, Tor K. Larsen, Ingrid Melle, Stein Opjordsmoen, Bjørn Rishovd Rund, Erik Simonsen.
Received: January 23, 2007
Accepted after revision: October 22, 2007
Published online: July 19, 2008
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 3, Number of References : 26
Psychopathology (International Journal of Descriptive and Experimental Psychopathology, Phenomenology and Psychiatric Diagnosis)
Vol. 41, No. 5, Year 2008 (Cover Date: August 2008)
Journal Editor: Mundt C. (Heidelberg), Akiskal H.S. (San Diego, Calif.), Mezzich J.E. (New York, N.Y.)
ISSN: 0254–4962 (Print), eISSN: 1423–033X (Online)
For additional information: http://www.karger.com/PSP