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The onset and offset of psychosis – and what happens in between

A commentary on ‘Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 Study’ by Morgan et al. (2014)

Published online by Cambridge University Press:  06 June 2014

J. J. McGrath ,
J. Miettunen ,
E. Jääskeläinen  and
F. Dark
J. J. McGrath*
Affiliation:
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
J. Miettunen
Affiliation:
Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland Institute of Health Sciences, University of Oulu, Oulu, Finland Medical Research Centre, University of Oulu and Oulu University Hospital, Oulu, Finland
E. Jääskeläinen
Affiliation:
Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland Medical Research Centre, University of Oulu and Oulu University Hospital, Oulu, Finland
F. Dark
Affiliation:
Rehabilitation Academic Clinical Unit, Metro South Mental Health Services, McGregor, QLD, Australia
*
* Address for correspondence: J. J. McGrath, Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia. (Email: [email protected])
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Abstract

As one would expect for a heterogeneous syndrome like schizophrenia, at the individual level the course of symptoms and disability vary widely. Mindful that the definition of recovery/remission varies widely between studies, a recent systematic review and meta-analysis reported that the proportion of those with schizophrenia who recover on both symptom and functional outcome is modest (approximately 14%). A 10-year follow-up of the English multicentre AESOP incidence study provides more ‘fine-grained’ insights into the time course of symptom fluctuation for schizophrenia and other psychotic disorders. We highlight selected findings from the new study and speculate on the role of different outcome domains for future study (e.g. symptom, occupational/functional, cognition, physical health, patient-nominated outcomes). Because recovery is a multifaceted process, we need to develop a panel of practical and operationalizable criteria for remission and recovery.

Keywords

Epidemiologyfirst-episode psychosisrecoveryremissionschizophrenia
Type
Commentary
Information
Psychological Medicine , Volume 44 , Issue 13 , October 2014 , pp. 2705 - 2711
Copyright
Copyright © Cambridge University Press 2014 

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