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The impact of manic symptoms in first‐episode psychosis : findings from the UK National EDEN study
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Marwaha, Steven, Hett, Danielle, Johnson, Sonia, Fowler, David, Hodgekins, Joanne, Freemantle, Nick, McCrone, Paul, Everard, Linda, Jones, Peter, Amos, Tim, Singh, Swaran P., Sharma, Vimal and Birchwood, Max (2021) The impact of manic symptoms in first‐episode psychosis : findings from the UK National EDEN study. Acta Psychiatrica Scandinavica, 144 (4). pp. 358-367. doi:10.1111/acps.13307 ISSN 1600-0447.
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Official URL: https://doi.org/10.1111/acps.13307
Abstract
Objective
The extant literature is inconsistent over whether manic symptoms in first-episode psychosis (FEP) impact on its development and trajectory. This study addressed the following: (1) Does Duration of Untreated Illness (DUI) and Duration of Untreated Psychosis (DUP) differ between FEP patients with and without manic symptoms? (2) Do manic symptoms in FEP have an impact on time to remission over 1 year?
Methods
We used data from the National EDEN study, a longitudinal cohort of patients with FEP accessing early intervention services (EIS) in England, which measured manic, positive and negative psychotic symptoms, depression and functioning at service entry and 1 year. Data from 913 patients with FEP (639 without manic symptoms, 237 with manic symptoms) were analysed using both general linear modelling and survival analysis.
Results
Compared to FEP patients without manic symptoms, those with manic symptoms had a significantly longer DUI, though no difference in DUP. At baseline, people with manic symptoms had higher levels of positive and negative psychotic symptoms, depression and worse functioning. At 12 months, people with manic symptoms had significantly poorer functioning and more positive psychotic symptoms. The presence of manic symptoms delayed time to remission over 1 year. There was a 19% reduced rate of remission for people with manic symptoms compared to those without.
Conclusions
Manic symptoms in FEP are associated with delays to treatment. This poorer trajectory persists over 1 year. They appear to be a vulnerable and under-recognised group for poor outcome and need more focussed early intervention treatment.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||
| SWORD Depositor: | Library Publications Router | ||||||||
| Journal or Publication Title: | Acta Psychiatrica Scandinavica | ||||||||
| Publisher: | Wiley | ||||||||
| ISSN: | 1600-0447 | ||||||||
| Official Date: | October 2021 | ||||||||
| Dates: |
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| Volume: | 144 | ||||||||
| Number: | 4 | ||||||||
| Page Range: | pp. 358-367 | ||||||||
| DOI: | 10.1111/acps.13307 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Reuse Statement (publisher, data, author rights): | "This is the peer reviewed version of the following article: Marwaha, S., Hett, D., Johnson, S., Fowler, D., Hodgekins, J., Freemantle, N., McCrone, P., Everard, L., Jones, P., Amos, T., Singh, S., Sharma, V. and Birchwood, M. (2021), The impact of manic symptoms in first-episode psychosis: Findings from the UK National EDEN study. Acta Psychiatr Scand. , which has been published in final form at https://doi.org/10.1111/acps.13307. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 14 February 2023 | ||||||||
| Date of first compliant Open Access: | 14 February 2023 | ||||||||
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