Poor outcome associated with symptomatic deterioration among help-seeking individuals at risk for psychosis: a naturalistic follow-up study
Article first published online: 24 JAN 2013
© 2013 Wiley Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 8, Issue 1, pages 24–31, February 2014
How to Cite
Morita, K., Kobayashi, H., Takeshi, K., Tsujino, N., Nemoto, T. and Mizuno, M. (2014), Poor outcome associated with symptomatic deterioration among help-seeking individuals at risk for psychosis: a naturalistic follow-up study. Early Intervention in Psychiatry, 8: 24–31. doi: 10.1111/eip.12032
- Issue published online: 27 JAN 2014
- Article first published online: 24 JAN 2013
- Manuscript Accepted: 30 SEP 2012
- Manuscript Received: 15 MAY 2012
- at-risk mental states;
- early intervention;
- quality of life
It remains debatable whether early intervention for psychosis is capable of meeting the needs of at-risk subjects. The aims of this study were to describe the actual impact of interventions on subjective difficulties and to explore the factors that may be associated with a poor outcome.
Participants were help-seeking outpatients at a university hospital who met the Criteria of Prodromal Syndromes. Changes in the symptoms, subjective experience and current insight were assessed using the Scales of Prodromal Symptoms, the Subjective Well-being under Neuroleptics, and the Scale to Assess Unawareness of Mental Disorder, respectively. Global functioning, social functioning and subjective quality of life were evaluated using the Global Assessment of Functioning Scale, the Social Functioning Scale, and the WHO-Quality of Life 26, respectively. These measures were assessed both at baseline and after 1 year.
Forty-six patients agreed to participate. Of the 27 patients who completed the reassessment at the follow-up point, 13 patients (48%) showed little improvement in their positive/negative symptoms, subjective well-being or awareness of their symptoms. Additionally, less severe negative symptoms, more severe general symptoms and lower subjective well-being at baseline significantly predicted a deterioration of positive/negative symptoms after 1 year.
Our findings suggest that the current strategy for reducing psychosis risk based on positive symptoms should be reappraised.