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Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors.

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Title: Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors.
Authors: Demjaha, A., Patel1, M. X., MacCabe, J. H., Reininghaus, U. A., Lomas, B., Charalambides, M., Onyejiaka, A., Murray, R. M., Morgan, C., Dazzan, P., Howes, O. D., Lappin, J. M., Stahl, D., Heslin, M., Donoghue, K., Fearon, P., Jones, P., Doody, G.
Source: Psychological Medicine. Aug2017, Vol. 47 Issue 11, p1981-1989. 9p.
Subjects: Clozapine, Drug therapy for psychoses, Drug therapy for schizophrenia, Antipsychotic agents, Age factors in disease, Demography, Drug resistance, Drugs, Longitudinal method, Multivariate analysis, Patient compliance, Multiple regression analysis, Treatment effectiveness, Disease prevalence, Severity of illness index, Disease duration, Therapeutics
Abstract: Background. We examined longitudinally the course and predictors of treatment resistance in a large cohort of firstepisode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors. Method. The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow- up period to determine the presence, course and predictors of treatment resistance. Results. From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset and longer duration of untreated psychosis predicted treatment resistance from illness onset. Conclusions. The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors.
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  Data: <searchLink fieldCode="AR" term="%22Demjaha%2C+A%2E%22">Demjaha, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Patel1%2C+M%2E+X%2E%22">Patel1, M. X.</searchLink><br /><searchLink fieldCode="AR" term="%22MacCabe%2C+J%2E+H%2E%22">MacCabe, J. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Reininghaus%2C+U%2E+A%2E%22">Reininghaus, U. A.</searchLink><br /><searchLink fieldCode="AR" term="%22Lomas%2C+B%2E%22">Lomas, B.</searchLink><br /><searchLink fieldCode="AR" term="%22Charalambides%2C+M%2E%22">Charalambides, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Onyejiaka%2C+A%2E%22">Onyejiaka, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Murray%2C+R%2E+M%2E%22">Murray, R. M.</searchLink><br /><searchLink fieldCode="AR" term="%22Morgan%2C+C%2E%22">Morgan, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Dazzan%2C+P%2E%22">Dazzan, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Howes%2C+O%2E+D%2E%22">Howes, O. D.</searchLink><br /><searchLink fieldCode="AR" term="%22Lappin%2C+J%2E+M%2E%22">Lappin, J. M.</searchLink><br /><searchLink fieldCode="AR" term="%22Stahl%2C+D%2E%22">Stahl, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Heslin%2C+M%2E%22">Heslin, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Donoghue%2C+K%2E%22">Donoghue, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Fearon%2C+P%2E%22">Fearon, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Jones%2C+P%2E%22">Jones, P.</searchLink><br /><searchLink fieldCode="AR" term="%22Doody%2C+G%2E%22">Doody, G.</searchLink>
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– Name: Abstract
  Label: Abstract
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  Data: Background. We examined longitudinally the course and predictors of treatment resistance in a large cohort of firstepisode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors. Method. The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow- up period to determine the presence, course and predictors of treatment resistance. Results. From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset and longer duration of untreated psychosis predicted treatment resistance from illness onset. Conclusions. The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=128265696
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        Value: 10.1017/S0033291717000435
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        Text: English
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