Lally, J; Ajnakina, O; Stubbs, B; Cullinane, M; Murphy, KC; Gaughran, F; Murray, RM; (2017) Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies. The British Journal of Psychiatry , 211 (6) pp. 350-358. 10.1192/bjp.bp.117.201475.

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Abstract

Background: Remission and recovery rates for people with first-episode psychosis (FEP) remain uncertain. Aims: To assess pooled prevalence rates of remission and recovery in FEP and to investigate potential moderators. Method: We conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies with more than 1 year of follow-up data, and conducted meta-regression analyses to investigate potential moderators. Results: Seventy-nine studies were included representing 19072 patients with FEP. The pooled rate of remission among 12301 individuals with FEP was 58% (60 studies, mean follow-up 5.5 years). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 38% (35 studies, mean follow-up 7.2 years). Recovery rates were higher in North America than in other regions. Conclusions: Remission and recovery rates in FEP may be more favourable than previously thought. We observed stability of recovery rates after the first 2 years, suggesting that a progressive deteriorating course of illness is not typical. Although remission rates have improved over time recovery rates have not, raising questions about the effectiveness of services in achieving improved recovery.

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