First-episode psychosis: Diagnostic stability over one and two years

Ulrik Haahr*, Svein Friis, Tor K. Larsen, Ingrid Melle, Jan Olav Johannessen, Stein Opjordsmoen, Erik Simonsen, Bjørn Rishovd Rund, Per Vaglum, Thomas McGlashan

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

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.

OriginalsprogEngelsk
Sider (fra-til)322-329
Antal sider8
TidsskriftPsychopathology
Vol/bind41
Udgave nummer5
DOI
StatusUdgivet - 1 aug. 2008

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