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Pardo-de-Santayana G, Juncal-Ruiz M, Vázquez-Bourgon J, Riesco-Dávila L, Ortiz-Garcia de la Foz V, Pelayo-Terán JM, López-Hoyos M, Crespo-Facorro B. Active psychosis and pro-inflammatory cytokines in first-episode of psychosis. J Psychiatr Res 2021; 134:150-7. [PMID: 33385633 DOI: 10.1016/j.jpsychires.2020.12.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/19/2020] [Accepted: 12/19/2020] [Indexed: 11/23/2022]
Abstract
Higher levels of pro-inflammatory cytokines are consistently found in the serum of first episode psychosis (FEP) patients and this immune dysfunction could contribute to neural harm. On the other hand, lengthy periods of active psychosis during the early phases of the illness appear to be associated to worst functional outcome. We aim to explore the possible relationship between lengthy periods of active psychosis during early phases of the illness and the levels of pro-inflammatory cytokines. This is a prospective clinical study consisting of a 3-year clinical follow-up. We assessed the relation between the duration of active psychosis in patients with FEP and the serum levels of 21 cytokines at baseline and 3 months after initiating antipsychotic medication. We used the Human High Sensitivity T Cell Magnetic Bead Panel protocol from the Milliplex® Map Kit. The sample consisted of 59 patients with a FEP. The percentage of variation of the serum levels of the chemokine MIP-3α during the first 3 months of antipsychotic treatment and the score in negative psychotic symptoms 3 months after the initiation of antipsychotic medication, acted as predictors of the initial time to remission of positive psychotic symptoms. Our findings open the possibility to investigating the potential use of the variation in chemokine MIP-3α serum levels during the first months of antipsychotic treatment to identify a subtype of FEP patients that could benefit from an add-on treatment with immune modulators. CLINICALTRIALS.GOV ID: NCT02897167. DATE OF FIRST REGISTRATION: September 13, 2016. "Study of the Activation of Proinflammatory Pathways of Toll-like Receptors in Schizophrenia Patients (PAFIP_TLR)". https://clinicaltrials.gov/ct2/show/NCT02897167.
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Pardo-de-Santayana G, Vázquez-Bourgon J, Gómez-Revuelta M, Ayesa-Arriola R, Ortiz-Garcia de la Foz V, Crespo-Facorro B, Pelayo-Terán JM; PAFIP research group. Duration of active psychosis during early phases of the illness and functional outcome: The PAFIP 10-year follow-up study. Schizophr Res 2020; 220:240-7. [PMID: 32276867 DOI: 10.1016/j.schres.2020.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 02/21/2020] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Longer duration of active psychosis (presence of positive psychotic symptoms) has been associated to worsening of functional and symptomatic outcome in patients with a first-episode of psychosis. There could be a "critical period" of increased brain vulnerability in the early phases of the illness when the effect of active psychosis would be exceptionally pernicious. OBJECTIVES We aim to explore the impact of lengthy periods of active psychosis during early phases of illness on long-term functional outcome. METHODS This is a prospective clinical study. We assessed the effect of the duration active psychosis in patients with a first-episode of nonaffective psychosis on long-term social functioning and functional recovery. The study consisted of a 3-year clinical follow-up and a functional evaluation performed after a 10-year period. RESULTS The sample consisted of 169 patients with a first-episode of non-affective psychosis. The duration of active psychosis after treatment (DAT) during the 3-year clinical follow-up acted as predictor of social functioning at the 10-year functional evaluation (Wald: 10.705; p = .001), but not of functional recovery. The duration of untreated psychosis (DUP) did not act as a predictor of any of the two long-term measures of functional outcome. CONCLUSIONS Active psychosis in early phases of the illness seems to be correlated to worst long-term functionality. In this study the duration of active psychosis after treatment (DAT) was a better predictor of long-term outcome than the duration of untreated psychosis (DUP). Reducing DAT should be considered an important objective for early intervention programs.
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Pardo-de-Santayana G, Vázquez-Bourgon J, Gómez-Revuelta M, Ayesa-Arriola R, Ortiz-Garcia de la Foz V, Crespo-Facorro B, Pelayo-Terán JM. Data regarding active psychosis and functional outcome, among other clinical variables, during early phases of the illness in first-episode psychosis in the PAFIP 10-year follow-up program. Data Brief 2020; 30:105599. [PMID: 32395579 PMCID: PMC7210416 DOI: 10.1016/j.dib.2020.105599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/08/2020] [Accepted: 04/15/2020] [Indexed: 10/26/2022] Open
Abstract
This article describes data related to the research study entitled "Duration of active psychosis during early phases of the illness and functional outcome: The PAFIP 10-year follow-up study." [1]. We present data concerning the clinical and sociodemographic characteristics of a sample of drug-naïve patients with a first episode of non-affective psychosis. The dataset was obtained from a 3-year longitudinal intervention program as part of an ongoing 10-year epidemiological study. The tables and figure shown present the data from the analysis between the active psychosis (presence of positive psychotic symptoms), among other sociodemographic and clinical predictor variables, recorded during the 3-year longitudinal intervention program and the evaluation of the functional outcome (social functioning and functional recovery) present at the 10-year mark. The data explores how those early parameters could influence long-term outcome.
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Affiliation(s)
- Guillermo Pardo-de-Santayana
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Victor Ortiz-Garcia de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Virgen del Rocio University Hospital-IBIS, Seville University
| | - José María Pelayo-Terán
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, CIBERSAM, School of Medicine, University of Cantabria, Santander, Spain.,Department of Psychiatry and Mental Health, El Bierzo Hospital, GASBI, SACYL, CIBERSAM, Ponferrada, León, Spain
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Pelayo-Terán JM, Gajardo-Galán V, Gómez-Revuelta M, Ortiz-García de la Foz V, Ayesa-Arriola R, Tabarés-Seisdedos R, Crespo-Facorro B. Duration of active psychosis and functional outcomes in first-episode non-affective psychosis. Eur Psychiatry 2018; 52:29-37. [PMID: 29614389 DOI: 10.1016/j.eurpsy.2018.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The duration of untreated psychosis (DUP) has been associated with negative outcomes in psychosis; however, few studies have focused on the duration of active psychotic symptoms after commencing treatment (DAT). In this study, we aimed to evaluate the effect of DUP and DAT on functional long-term outcomes (3 years) in patients with early psychosis. METHODS We evaluated the Scale for the Assessment of Positive Symptoms (SAPS) at frequent intervals for 3 years after presentation to determine the DAT for 307 individuals with first-episode psychosis together with DUP and clinical variables. The functional outcomes were assessed using the Disability Assessment Scale (DAS) at three years, and functional recovery was defined as minimal impairment and return to activity. Associated variables, DAT and DUP were included in logistic regression models to predict functional outcomes. Receiver operating characteristic curves and Youden's index were applied to assess the best cut-off values. RESULTS DAT, (Wald: 13.974; ExpB: 1.097; p < 0.001), premorbid adjustment, initial BPRS score, gender, age of onset and schizophrenia diagnosis were significant predictors of social functioning, whereas only premorbid adjustment (Wald: 11.383; ExpB:1.009), DAT (Wald: 4.850; ExpB: 1.058; p = 0.028) and education were significant predictors of recovery. The optimal cut-off of DAT for predicting social functioning was 3.17 months for DAT (sensitivity: 0.68; specificity: 0.64; Youden's index: 0.314). CONCLUSIONS DAT is strongly related to functional outcomes independent of the DUP period or other variables. As a modifiable variable, the reduction of the DAT should be considered a main focus of intervention from the onset of the illness to improve long-term outcomes.
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Affiliation(s)
- José María Pelayo-Terán
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Unidad de Gestión Clínica de Psiquiatría y Salud Mental, Hospital El Bierzo, Servicio de Salud de Castilla y León (SACYL), Ponferrada, León, Spain.
| | - Virginia Gajardo-Galán
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Hospital de Merida, Servicio Estremeño de Salud (SES), Mérida, Badajoz, Spain
| | - Marcos Gómez-Revuelta
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Victor Ortiz-García de la Foz
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Rosa Ayesa-Arriola
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Rafael Tabarés-Seisdedos
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain; Department of Psychiatry, University of Valencia, CIBERSAM, Valencia, Spain
| | - Benedicto Crespo-Facorro
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
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On ZX, Cotton S, Farhall J, Killackey E, Allott K. Relationship between duration of untreated psychosis and neurocognition and social cognition in first-episode psychosis. Schizophr Res 2016; 176:529-532. [PMID: 27344985 DOI: 10.1016/j.schres.2016.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/09/2016] [Accepted: 06/16/2016] [Indexed: 11/28/2022]
Abstract
Cognitive impairment is common in first-episode psychosis (FEP); however, the relationship between duration of untreated psychosis (DUP) and neurocognition remains controversial, and no studies have examined the relationship between DUP and social cognition. This study involved secondary data analysis of baseline data from a randomised controlled trial of supported employment; 122 out 146 young people with FEP met inclusion criteria for this study. Results showed that DUP was not associated with neurocognitive or social cognitive performance. Results do not provide support for the neurotoxicity hypothesis of psychosis.
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Affiliation(s)
- Zhi Xiang On
- Department of Psychology and Counselling, La Trobe University, Australia
| | - Susan Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Australia
| | - Eóin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia.
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