A naturalistic cohort study of first-episode schizophrenia spectrum disorder: A description of the early phase of illness in the PSYSCAN cohort.

Mar 04, 2024

Experts: Margot I E Slot, Hendrika H van Hell, Inge Winter-van Rossum, Paola Dazzan, Arija Maat, Lieuwe de Haan, Benedicto Crespo-Facorro, Birte Glenthøj, Stephen M Lawrie, Colm McDonald, Oliver Gruber, Thérèse van Amelsvoort, Celso Arango, Tilo Kircher, Barnaby Nelson, Silvana Galderisi, Mark Weiser, Gabriele Sachs, Anke Maatz, Rodrigo A Bressan, Jun Soo Kwon, Romina Mizrahi, , Philip McGuire, René S Kahn

We examined the course of illness over a 12-month period in a large, international multi-center cohort of people with a first-episode schizophrenia spectrum disorder (FES) in a naturalistic, prospective study (PSYSCAN).
Patients with a first episode of schizophrenia, schizoaffective disorder (depressive type) or schizophreniform disorder were recruited at 16 institutions in Europe, Israel and Australia. Participants (N = 304) received clinical treatment as usual throughout the study.
The mean age of the cohort was 24.3 years (SD = 5.6), and 67 % were male. At baseline, participants presented with a range of intensities of psychotic symptoms, 80 % were taking antipsychotic medication, 68 % were receiving psychological treatment, with 46.5 % in symptomatic remission. The mean duration of untreated psychosis was 6.2 months (SD = 17.0). After one year, 67 % were in symptomatic remission and 61 % were in functional remission, but 31 % had been readmitted to hospital at some time after baseline. In the cohort as a whole, depressive symptoms remained stable over the follow-up period. In patients with a current depressive episode at baseline, depressive symptoms slightly improved. Alcohol, tobacco and cannabis were the most commonly used substances, with daily users of cannabis ranging between 9 and 11 % throughout the follow-up period.
This study provides valuable insight into the early course of a broad range of clinical and functional aspects of illness in FES patients in routine clinical practice.

Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

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ABOUT THE EXPERTS

Margot I E Slot, Hendrika H van Hell, Inge Winter-van Rossum, Paola Dazzan, Arija Maat, Lieuwe de Haan, Benedicto Crespo-Facorro, Birte Glenthøj, Stephen M Lawrie, Colm McDonald, Oliver Gruber, Thérèse van Amelsvoort, Celso Arango, Tilo Kircher, Barnaby Nelson, Silvana Galderisi, Mark Weiser, Gabriele Sachs, Anke Maatz, Rodrigo A Bressan, Jun Soo Kwon, Romina Mizrahi, , Philip McGuire, René S Kahn

Margot I E Slot

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: I.E.Slot-3@umcutrecht.nl.

Hendrika H van Hell

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: H.H.vanHell-2@umcutrecht.nl.

Inge Winter-van Rossum

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America. Electronic address: I.Winter@umcutrecht.nl.

Paola Dazzan

Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London SE5 8AF, United Kingdom. Electronic address: paola.dazzan@kcl.ac.uk.

Arija Maat

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands. Electronic address: A.Maat@umcutrecht.nl.

Lieuwe de Haan

Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: l.dehaan@amsterdamumc.nl.

Benedicto Crespo-Facorro

CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychiatry, University of Sevilla. Hospital Universitario Virgen del Rocio, IBiS-CSIC, Sevilla, Spain. Electronic address: benedicto.crespo@unican.es.

Birte Glenthøj

Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Dept. of Clinical Medicine, Copenhagen, Denmark. Electronic address: birte.glenthoj@cnsr.dk.

Stephen M Lawrie

Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, United Kingdom. Electronic address: s.lawrie@ed.ac.uk.

Colm McDonald

Centre for Neuroimaging & Cognitive Genomics (NICOG), Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland. Electronic address: colm.mcdonald@nuigalway.ie.

Oliver Gruber

Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany. Electronic address: oliver.gruber@med.uni-heidelberg.de.

Thérèse van Amelsvoort

Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Centre, Maastricht, the Netherlands. Electronic address: t.vanamelsvoort@maastrichtuniversity.nl.

Celso Arango

Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Centro de Investigación Biomédica en Red del área de Salud Mental (CIBERSAM), Madrid, Spain. Electronic address: carango@hggm.es.

Tilo Kircher

Department of Psychiatry, University of Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany. Electronic address: kircher@med.uni-marburg.de.

Barnaby Nelson

Orygen, 35 Poplar Road, Parkville, Victoria, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia. Electronic address: barnaby.nelson@orygen.org.au.

Silvana Galderisi

University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy.

Mark Weiser

Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: mweiser@netvision.net.il.

Gabriele Sachs

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria. Electronic address: gabriele.sachs@meduniwien.ac.at.

Anke Maatz

Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland. Electronic address: anke.maatz@pukzh.ch.

Rodrigo A Bressan

Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil.

Jun Soo Kwon

Department of Psychiatry, Seoul National University College of Medicine, 101 Dahakno, Jongno-gu, Seoul, Republic of Korea. Electronic address: kwonjs@snu.ac.kr.

Romina Mizrahi

Department of Psychiatry, McGill University, Montreal, Canada. Electronic address: romina.mizrahi@mcgill.ca.

Philip McGuire

Department of Psychiatry, University of Oxford, Oxford, United Kingdom. Electronic address: philip.mcguire@psych.ox.ac.uk.

René S Kahn

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America. Electronic address: rene.kahn@mssm.edu.