(2021) Development and validation of a nonremission risk prediction model in first-episode psychosis : an analysis of 2 longitudinal studies. Schizophrenia Bulletin Open, 2 (1). sgab041,. doi:10.1093/schizbullopen/sgab041 ISSN 2632-7899.
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Abstract
Psychosis is a major mental illness with first onset in young adults. The prognosis is poor in around half of the people affected, and difficult to predict. The few tools available to predict prognosis have major weaknesses which limit their use in clinical practice. We aimed to develop and validate a risk prediction model of symptom nonremission in first-episode psychosis. Our development cohort consisted of 1027 patients with first-episode psychosis recruited between 2005 and 2010 from 14 early intervention services across the National Health Service in England. Our validation cohort consisted of 399 patients with first-episode psychosis recruited between 2006 and 2009 from a further 11 English early intervention services. The one-year nonremission rate was 52% and 54% in the development and validation cohorts, respectively. Multivariable logistic regression was used to develop a risk prediction model for nonremission, which was externally validated. The prediction model showed good discrimination C-statistic of 0.73 (0.71, 0.75) and adequate calibration with intercept alpha of 0.12 (0.02, 0.22) and slope beta of 0.98 (0.85, 1.11). Our model improved the net-benefit by 15% at a risk threshold of 50% compared to the strategy of treating all, equivalent to 15 more detected nonremitted first-episode psychosis individuals per 100 without incorrectly classifying remitted cases. Once prospectively validated, our first episode psychosis prediction model could help identify patients at increased risk of nonremission at initial clinical contact.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RC Internal medicine R Medicine > RJ Pediatrics |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| SWORD Depositor: | Library Publications Router |
| Library of Congress Subject Headings (LCSH): | Psychoses, Psychoses in adolescence , Manic-depressive illness in adolescence , Psychoses in adolescence -- Treatment, Schizophrenia -- Longitudinal studies , Schizophrenics |
| Journal or Publication Title: | Schizophrenia Bulletin Open |
| ISSN: | 2632-7899 |
| Official Date: | 21 August 2021 |
| Dates: | Date Event 21 August 2021 Published |
| Volume: | 2 |
| Number: | 1 |
| Article Number: | sgab041, |
| DOI: | 10.1093/schizbullopen/sgab041 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Open Access (Creative Commons open licence) |
| Date of first compliant deposit: | 29 November 2021 |
| Date of first compliant Open Access: | 2 December 2021 |
| RIOXX Funder/Project Grant: | Project/Grant ID RIOXX Funder Name Funder ID RP-PG-0109-10074 [NIHR] National Institute for Health Research CAF/19/04 Chief Scientist Office, Scottish Government Health and Social Care Directorate |
| URI: | https://wrap.warwick.ac.uk/159802/ |
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