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The impact of manic symptoms in first-episode psychosis: Findings from the UK National EDEN study

Marwaha, S; Hett, D; Johnson, S; Fowler, D; Hodgekins, J; Freemantle, N; McCrone, P; ... Birchwood, M; + view all (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. 10.1111/acps.13307. Green open access

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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: 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.

Type: Article
Title: The impact of manic symptoms in first-episode psychosis: Findings from the UK National EDEN study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/acps.13307
Publisher version: https://doi.org/10.1111/acps.13307
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: (FEP) Early intervention Services (EIS), Duration of untreated illness (DUI), Duration of untreated psychosis (DUP), Mania, affective psychosis, first-episode psychosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > Comprehensive CTU at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10126411
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