Predictors of outcome in the early course of first-episode psychosis

Background and Objectives: The identification of characteristics that predict clinical and functional outcomes in patients with schizophrenia and related psychotic disorders is essential for enhancing our understanding of the pathophysiology and the treatment of the disorder. The present study employed a retrospective design to examine the predictive validity of demographic, clinical, and psychosocial characteristics of firstepisode patients on diagnosis, presence of residual psychotic symptoms, and number of psychotic episodes three to five years later. Methods: Information on baseline predictor variables and outcome was obtained from the clinical records of 44 patients who had their first psychotic episode between 1999 and 2003 and whose available follow-up period was at least 3 years long (mean = 5.7 years, SD = 1.3 years). Results: Male gender, single marital status, and poor premorbid adjustment were significantly associated with residual symptoms at follow-up. Poor insight at onset was significantly associated with subsequent relapses. Diagnosis of schizophrenia (as opposed to other psychotic disorders) at the follow-up assessment showed no significant association with any of the baseline predictors. Conclusions: Consistent with previous findings, the constellation of male gender, single status, poor premorbid adjustment and poor insight appeared to predict especially poor outcome. Residual symptoms appear to be an especially useful index of clinical and functional status for examining the course and outcome of first-episode psychosis.