Psychopathology trajectories and relapse in first episode schizophrenia with assured long-acting injectable adherence over 24 months

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-02-01 DOI:10.1016/j.schres.2025.01.007

Smit Retha, Luckhoff Hilmar, Phahladira Lebogang, Kilian Sanja, Emsley Robin, Asmal Laila

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引用次数: 0

Abstract

Background

Relapse following a first episode of schizophrenia (FES) is common and often results in serious adverse psychosocial consequences. Treatment non-adherence is a key risk factor for relapse, but why relapse occurs despite antipsychotic treatment adherence remains unclear. This study examined the differences in FES psychopathology trajectories over 24-months with assured long-acting injectable antipsychotic (LAIA) treatment, to control for treatment adherence between those who relapsed and those who did not and what moderates these group differences.

Methodology

We collected clinical and socio-demographic data from 107 participants with FES treated with LAIA medication over a 24-month period. Relapse was defined using the modified Csernansky criteria. Substance use was assessed through participant and family interviews and urine toxicology. Linear mixed model repeated measures models were constructed to (1) compare psychopathology trajectories over 24 months between relapse versus non-relapse groups (2) to examine factors moderating differential trajectories between the groups.

Results

Positive symptom trajectories were significantly worse in the relapse compared to non-relapse group over 24 months (F(8, 649 = 3.29), p = 0.001). More severe childhood trauma (CT), in particular physical abuse (PA) (F(39, 298 = 1.78), p = 0.004), was associated with worse positive symptom trajectories over 24 months in those who experienced a relapse event.

Conclusion

Our findings suggest that the examination of a history of CT and, in particular childhood PA measures for relapse in individuals with FES, is important.

查看原文本刊更多论文

首次发作精神分裂症的精神病理轨迹和复发，保证24个月以上的长效注射依从性。

背景：精神分裂症（FES）首发后复发是常见的，往往导致严重的不良心理社会后果。治疗依从性不强是复发的关键危险因素，但为什么尽管坚持抗精神病药物治疗仍会复发尚不清楚。本研究检查了FES精神病理轨迹在24个月内使用长效注射抗精神病药物（LAIA）治疗的差异，以控制复发组和未复发组之间的治疗依从性，以及缓和这些组差异的因素。方法：我们收集了107名接受LAIA治疗的FES患者在24个月期间的临床和社会人口学数据。复发定义采用改良的Csernansky标准。通过参与者和家庭访谈以及尿液毒理学来评估药物使用情况。建立了线性混合模型重复测量模型(1)比较复发组和非复发组之间24个月的精神病理轨迹(2)来检查调节组间差异轨迹的因素。结果：24个月内，复发组阳性症状轨迹明显差于非复发组（F(8,649 = 3.29), p = 0.001）。更严重的童年创伤（CT），特别是身体虐待（PA）（F(39, 298 = 1.78), p = 0.004），在经历复发事件的患者中，24个月内阳性症状轨迹更差。结论：我们的研究结果表明，检查CT病史，特别是儿童时期的PA测量对于FES患者的复发是很重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.