医学
抗精神病药
内科学
精神分裂症(面向对象编程)
精神科
氯氮平
大麻
队列
精神病
药物滥用
儿科
作者
Miquel Bioque,Gisela Mezquida,Sílvia Amoretti,Clemente García-Rizo,Jose M. López-Ilundain,Covadonga M. Díaz‐Caneja,Iñaki Zorrilla,Anna Mané,Roberto Rodríguez‐Jiménez,Iluminada Corripio,Edith Pomarol‐Clotet,Ángela Ibáñez,Judith Usall,Fernando Hernández Contreras,Sergi Mas,Javier Vázquez‐Bourgon,Manuel J. Cuesta,Mara Parellada,Ana González‐Pinto,María Hidalgo-Figueroa,Miquel Bernardo
标识
DOI:10.1016/j.schres.2022.02.026
摘要
Relapses are frequent in the first years following a first episode of schizophrenia (FES), being associated with a higher risk of developing a chronic psychotic disorder, and poor clinical and functional outcomes. The identification and intervention over factors associated with relapses in these early phases are timely and relevant. In this study, 119 patients in remission after a FES were closely followed over three years. Participants came from the 2EPS Project, a coordinated, naturalistic, longitudinal study of 15 tertiary centers in Spain. Sociodemographic, clinical, treatment and substance abuse data were analyzed. 49.6% of the participants relapsed during the 3-years follow-up. None of the baseline demographic and clinical characteristics analyzed showed a statistically significant association with relapses. 22% of patients that finished the follow-up without relapsing were not taking any antipsychotic. The group that relapsed presented higher mean antipsychotics doses (381.93 vs. 242.29 mg of chlorpromazine equivalent/day, p = 0.028) and higher rates of antipsychotic polytherapy (28.6% vs. 13%, p < 0.001), benzodiazepines use (30.8% vs. 8.5%, p < 0.001), side effects reports (39.2% vs. 25%, p = 0.022), psychological treatment (51.8% vs. 33.9%, p = 0.03), and cannabis consumption (93.2% vs. 56.7%, p < 0.001). Clozapine use was notably higher in the group that reminded in remission (21.7% vs. 8.2%, p < 0.019). These findings may guide clinicians to detect subgroups of patients with higher risk to present a second episode of psychosis, focusing on measures to ensure an adequate treatment or facilitating cannabis use cessation. This study supports future research to identify relapse prevention strategies for patients in early phases of schizophrenia.
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