Antipsychotic medication and remission of psychotic symptoms 10 years after a first-episode psychosis

作者：Wils Regitze Solling^*; Gotfredsen Ditte Resendal; Hjorthoj Carsten; Austin Stephen F; Albert Nikolai; Secher Rikke Gry; Thorup Anne Amalie Elgaard; Mors Ole; Nordentoft Merete

来源：Schizophrenia Research, 2017, 182: 42-48.

DOI：10.1016/j.schres.2016.10.030

• Antipsychotic medication
• First episode psychosis
• Long-term outcome
• Schizophrenia

Background: Several national guidelines recommend continuous use of antipsychotic medication after a psychotic episode in order to minimize the risk of relapse. However some studies have identified a subgroup of patients who obtain remission of psychotic symptoms while not being on antipsychotic medication for a period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up.
Methods: The study was a cohort study including 496 patients diagnosed with schizophrenia spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10 years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication.
Findings: 61% of the patients from the original cohort attended the 10-year follow up and 30% of these had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This outcome was associated with female gender, high GAF-F score, participation in the labour market and absence of substance abuse.
Conclusion: Our results describe a subgroup of patients who obtained remission while not being on antipsychotic medication at the 10-year follow-up. The finding calls for further investigation on a more individualized approach to long-term treatment with antipsychotic medication.

• 出版日期2017-4
• 单位上海市精神卫生中心