سیر اختلال‌های پسیکوتیک: پیگیری سه‌ساله بیماران مبتلا به پسیکوز بار اول

Objectives: The goal of the current 3-year follow-up study was to investigate characteristics, course and clinical outcomes of a group of patients with first episode psychosis admitted to Roozbeh Hospital during 2007-2009. Method: Patients admitted to Roozbeh Hospital with a first presentation of any psychotic symptoms were included. At admission, the patients were assessed with regard to severity of symptoms, global functioning and quality of life. For data collection, the Positive and Negative Symptoms Scale (PANSS), Global Assessment of Functioning (GAF), and World Health Organization Quality of Life Scale-Brief (WHOQoL-BREF) were used. These assessments were repeated at the time of discharge, and on six, 12, and 24 months as well as three to four years after discharge. Readmissions in the follow-up period were also recorded. The data were analyzed using repeated measure analysis of variance and paired t-test. Results: Of 104 recruited patients, 59 (56.7%) were male. Their mean age (±SD) was 30.6 years (±9.7). Based on discharge diagnoses, 48 individuals had bipolar I disorder (with psychotic features), 22 patients had schizophrenia, seven cases had major depressive disorder (with psychotic features), and the remaining 27 were diagnosed with other psychotic disorders. Patients’ global functioning, and positive, negative and general psychotic symptoms were improved noticeably during follow-up. Nonetheless, the improvement was apparent at solely the time of discharge and none of these measures changed between discharge and follow-up intervals. The patients’ quality of life showed no changes during any of these intervals. Of those with available data, the rate of readmission was 41.1%. Conclusion: A significant proportion of the patients experienced relapse leading to rehopitalization during the first three years after the index hospitalization. This finding along with the lack of improvement of functioning and quality of life during the follow-up period underlines the importance of providing effective interventions for relapse prevention and rehabilitation