Psychotic disorders entail long-term management

01 Jul 2024
Psychotic disorders entail long-term management

A long-term healthcare plan appears necessary for people with psychotic disorders to detect and respond to changes in the trajectory of their disease course, suggests a study.

“The modal longitudinal pattern for individuals with other psychoses is one of multiple transitions into and out of symptomatic and functional recovery,” the researchers said.

This study involved participants from the Suffolk County Mental Health Project, an epidemiological study of first-admission psychosis. Researchers obtained data from six follow-ups and assessed 311 individuals at the 25-year follow-up. They examined the common patterns of remission and recovery in the baseline cohort of 591 individuals and the subsample from the 25-year follow-up.

The most common trajectory for people with schizophrenia spectrum disorders in the baseline cohort and the 25-year subsample was no remission and no recovery.

Individuals with other psychotic disorders, on the other hand, experienced a modal pattern of intermittent remission and recovery in both cohorts. They were also more likely to have stable remission (15.1 percent) and stable recovery (21.1 percent). Such outcomes were rare among individuals with schizophrenia spectrum disorders (0 percent and 0.6 percent, respectively).

“Sustained remission and recovery are rare among people with schizophrenia spectrum disorders. Efforts should be directed toward developing more effective treatments for this population,” according to the researchers.

“Understanding prognosis is critical to anticipating public health needs and providing care to individuals with psychotic disorders,” they said.

Am J Psychiatry 2024;181:532-540