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Ten-Year Outcomes of First-Episode Psychoses in the MRC ÆSOP-10 Study
Camice J Revier1, Ulrich Reininghaus, Rina Dutta
1*Department of Psychiatry, University of Cambridge, National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and NIHR Collaboration for Leadership in Applied Health Research & Care, Cambridge, UK; †Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK; ‡Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; §Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK; ∥Department of Psychiatry, Trinity College, Dublin, Ireland; ¶NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK; #Psychosis Studies Department, Institute of Psychiatry, King's College, London, UK; **Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK; ††Department of Nursing and Midwifery, University of Dundee, Dundee, UK; ‡‡Centre for Economics of Mental and Physical Health, Health Service and Population Research Department, Institute of Psychiatry, King's College, London, UK; §§Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience at King's College, London, UK; ∥∥Institute of Psychiatry, Psychology & Neuroscience at King's College, London, UK; ¶¶Department of Psychiatry, University of New South Wales, Sydney, NSW, Australia; ##Division of Psychiatry, University College London, London, UK; and ***Addictions Department, Institute of Psychiatry, King's College, London, UK.
Abstract:
It has long been held that schizophrenia and other psychotic disorders have a predominately poor course and outcome. We have synthesized information on mortality, clinical and social outcomes from the ÆSOP-10 multicenter study, a 10-year follow-up of a large epidemiologically characterized cohort of 557 people with first-episode psychosis. Symptomatic remission and recovery were more common than previously believed. Distinguishing between symptom and social recovery is important given the disparity between these; even when symptomatic recovery occurs social inclusion may remain elusive. Multiple factors were associated with an increased risk of mortality, but unnatural death was reduced by 90% when there was full family involvement at first contact compared with those without family involvement. These results suggest that researchers, clinicians and those affected by psychosis should countenance a much more optimistic view of symptomatic outcome than was assumed when these conditions were first described.
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