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Study looks at prediction of a single psychotic episode (Australia)

February 24, 2011

Early treatment intervention following psychosis and social support are among factors associated with reducing or preventing subsequent psychotic episodes, according to a recent Australian study.

Researchers focused on youth who had experienced a first-episode psychosis over a 7.5 year period. Out of the initial group of 413 youth interviewed through an early intervention program in Melbourne, Australia, 274 completed a follow-up interview 7.5 years later. Of the participants followed, 46 individuals (16.5 percent) experienced a single psychotic episode over the span of the study, while the majority (83.5 percent) experienced continuous or several episodes. The authors compared the two groups regarding sociodemographic and psychosocial variables, clinical variables, developmental factors, and psychopathology.

Shorter duration of untreated psychosis, quicker response to treatment, and having “no parental loss,” were the strongest early predictors associated with a single psychotic episode. The results indicate that individuals who experience first-episode psychosis and do not start treatment within 60 days were at a greater risk of developing subsequent psychotic episodes within 7.5 years than those who started treatment earlier. The researchers also found that the loss of one or both parents increased the risk of experiencing multiple psychotic episodes fourfold.

The authors acknowledge several limitations in the study’s scope. Because participants with poor English-language comprehension were excluded from the study, parental immigration as a factor associated with subsequent psychosis may have been underreported in the study. Also, the study cannot make any conclusions about social or psychiatric factors in the interim period, beyond the early predictors discussed. Finally, for those who experienced only a single episode, the possibility of experiencing further psychotic episodes is not eliminated beyond the first 7.5 years, however this time period extends well beyond the established critical period for subsequent psychosis.

See “Prediction of a Single Psychotic Episode: A 7.5-Year, Prospective Study in First-Episode Psychosis,” Schizophrenia Research (February 2011; 125[2]: 236-246), available at www.schres-journal.com.

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