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Conference Paper: Relapse predictors for discontinuing and continuing maintenance medication in remitted first-episode psychosis patients

TitleRelapse predictors for discontinuing and continuing maintenance medication in remitted first-episode psychosis patients
Authors
Issue Date2009
PublisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/
Citation
The 12th International Congress on Schizophrenia Research (ICOSR), San Diego, CA., 28 March-1 April 2009. In Schizophrenia Bulletin, 2009, v. 35 suppl. 1, p. 347-348, ID: 550229 How to Cite?
AbstractAfter a first-episode psychosis, patients inevitably face a clinical dilemma regarding whether to continue with maintenance medication after a period of remission. This decision has to be weighed against the long-term medication side effects and the risk of relapse. In this study, we aim to identify potential predictors for relapse among patients who have continued with maintenance medication, as well as those who have discontinued with maintenance medication. This is a double-blind randomized placebo-controlled study. Patients who were remitted from a first-episode of schizophrenia or non-affective psychosis (DSM-IV) and had remained well on maintenance medication for at least 1 year were recruited into this study. Eligible patients were randomized to either quetiapine (400mg/d) or placebo for 12 months to detect a relapse. Relapse was defined as re-emergence of definitive positive symptoms. Baseline clinical and cognitive variables were measured as potential predictors for relapse. Univariate and multivariate Cox-proportional hazards models were applied to analyze significant predictors in the maintenance medication and the placebo groups. A total of 178 patients were recruited. In the placebo group, significant multivariate relapse predictors were smoking (relative risk 4.317, 95% CI = 1.012–18.417), negative symptoms (relative risk 1.030, 95% CI = 1.008–1.053) and verbal fluency (relative risk 0.880, 95% CI = 0.807–0.960). In the medication group, significant multivariate relapse predictors were pre-morbid functioning (interest) (relative risk 1.641, 95% CI = 1.215–2.216), PANSS (general psychopathology) (relative risk 1.548, 95% CI = 1.089–2.200), logical memory at immediate recall (relative risk 0.879, 95% CI = 0.782–0.988) and neurological soft signs (disinhibition) (relative risk 3.423, 95% CI = 1.585–7.390). Importantly, predictors identified in the two groups help provide information about the characteristics of the patients who are more prone to relapse. Future intervention strategies for relapse prevention can be based on the current findings.
DescriptionThis journal suppl. entitled: Abstracts for the 12th International Congress on Schizophrenia Research (ICOSR)
Persistent Identifierhttp://hdl.handle.net/10722/62683
ISSN
2015 Impact Factor: 7.757
2015 SCImago Journal Rankings: 4.051
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorHui, CLMen_HK
dc.contributor.authorChen, EYHen_HK
dc.contributor.authorLam, MLMen_HK
dc.contributor.authorLaw, CWen_HK
dc.contributor.authorChiu, CPYen_HK
dc.contributor.authorChung, DWSen_HK
dc.contributor.authorTso, Sen_HK
dc.contributor.authorPang, EPFen_HK
dc.contributor.authorChan, KTen_HK
dc.contributor.authorWong, YCen_HK
dc.contributor.authorChan, K-
dc.contributor.authorHung, SF-
dc.contributor.authorYao, TJ-
dc.contributor.authorHoner, WG-
dc.date.accessioned2010-07-13T04:06:47Z-
dc.date.available2010-07-13T04:06:47Z-
dc.date.issued2009en_HK
dc.identifier.citationThe 12th International Congress on Schizophrenia Research (ICOSR), San Diego, CA., 28 March-1 April 2009. In Schizophrenia Bulletin, 2009, v. 35 suppl. 1, p. 347-348, ID: 550229en_HK
dc.identifier.issn0586-7614en_HK
dc.identifier.urihttp://hdl.handle.net/10722/62683-
dc.descriptionThis journal suppl. entitled: Abstracts for the 12th International Congress on Schizophrenia Research (ICOSR)-
dc.description.abstractAfter a first-episode psychosis, patients inevitably face a clinical dilemma regarding whether to continue with maintenance medication after a period of remission. This decision has to be weighed against the long-term medication side effects and the risk of relapse. In this study, we aim to identify potential predictors for relapse among patients who have continued with maintenance medication, as well as those who have discontinued with maintenance medication. This is a double-blind randomized placebo-controlled study. Patients who were remitted from a first-episode of schizophrenia or non-affective psychosis (DSM-IV) and had remained well on maintenance medication for at least 1 year were recruited into this study. Eligible patients were randomized to either quetiapine (400mg/d) or placebo for 12 months to detect a relapse. Relapse was defined as re-emergence of definitive positive symptoms. Baseline clinical and cognitive variables were measured as potential predictors for relapse. Univariate and multivariate Cox-proportional hazards models were applied to analyze significant predictors in the maintenance medication and the placebo groups. A total of 178 patients were recruited. In the placebo group, significant multivariate relapse predictors were smoking (relative risk 4.317, 95% CI = 1.012–18.417), negative symptoms (relative risk 1.030, 95% CI = 1.008–1.053) and verbal fluency (relative risk 0.880, 95% CI = 0.807–0.960). In the medication group, significant multivariate relapse predictors were pre-morbid functioning (interest) (relative risk 1.641, 95% CI = 1.215–2.216), PANSS (general psychopathology) (relative risk 1.548, 95% CI = 1.089–2.200), logical memory at immediate recall (relative risk 0.879, 95% CI = 0.782–0.988) and neurological soft signs (disinhibition) (relative risk 3.423, 95% CI = 1.585–7.390). Importantly, predictors identified in the two groups help provide information about the characteristics of the patients who are more prone to relapse. Future intervention strategies for relapse prevention can be based on the current findings.-
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/en_HK
dc.relation.ispartofSchizophrenia Bulletin-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleRelapse predictors for discontinuing and continuing maintenance medication in remitted first-episode psychosis patientsen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailHui, CLM: clmhui@hkusua.hku.hken_HK
dc.identifier.emailChen, EYH: eyhchen@hku.hken_HK
dc.identifier.emailLam, MLM: maylam11@hku.hken_HK
dc.identifier.emailLaw, CW: lawcw@hku.hken_HK
dc.identifier.emailChiu, CPY: chiupyc@hku.hk-
dc.identifier.emailYao, TJ: tjyao@hku.hk-
dc.identifier.authorityChen, EYH=rp00392en_HK
dc.identifier.authorityLam, MLM=rp00296en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1093/schbul/sbn173-
dc.identifier.pmid19252181-
dc.identifier.pmcidPMC2651108-
dc.identifier.hkuros163060en_HK
dc.identifier.volume35-
dc.identifier.issuesuppl. 1-
dc.identifier.spage347, ID: 550229-
dc.identifier.epage348-
dc.identifier.epage348, ID: 550229-
dc.publisher.placeUnited Kingdom-

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