Predictors of functional recovery in first-episode psychosis: A systematic review and meta-analysis of longitudinal studies

Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes. To systematically compile and analyse p...

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Bibliographic Details
Published in:Clinical psychology review 2017-12, Vol.58, p.59-75
Main Authors: Santesteban-Echarri, Olga, Paino, Mercedes, Rice, Simon, González-Blanch, César, McGorry, Patrick, Gleeson, John, Alvarez-Jimenez, Mario
Format: Article
Language:English
Subjects:
Early Medical Intervention - statistics & numerical data
First-episode psychosis
Functioning
Humans
Outcome Assessment (Health Care) - statistics & numerical data
Psychotic Disorders - therapy
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Summary:Three out of four first-episode psychosis (FEP) patients achieve clinical remission following treatment. Unfortunately, functional recovery lags behind symptomatic remission, and many individuals with FEP remain socially isolated with poor functional outcomes. To systematically compile and analyse predictors of functional recovery in FEP. Systematic review and meta-analysis of peer-reviewed, longitudinal studies reporting predictors of functioning, with a minimum 12-month follow-up and at least 80% of participants diagnosed with FEP. Out of 2205 citations, 274 articles were retrieved for detailed evaluation resulting in 50 eligible studies (N=6669). Sociodemographic, clinical, physical and neuroimaging variables had little impact on long-term functioning. Conversely duration of untreated psychosis (DUP), most cognitive variables, and concurrent remission of positive and negative symptoms were independently related to functional recovery. These findings strongly support the rationale for early intervention in FEP. Novel treatments targeting cognitive deficits may improve functional outcomes in FEP. •Systematic review and meta-analysis•All predictors of functional recovery in first-episode psychosis patients•Shorter duration of untreated psychosis as an important predictor of functioning•Cognitive variables as predictors of long-term functioning•Importance of early intervention in first-episode psychosis
ISSN:0272-7358
1873-7811
DOI:10.1016/j.cpr.2017.09.007