Developing a Risk-Model of Time to First-Relapse for Children and Adolescents With a Psychotic Disorder

Individuals treated for psychotic disorders and mood disorders with psychotic features have a high likelihood of relapse across the life course. This study examines the relapse rate and its associated predictors for children and adolescents experiencing a first-episode and develops a statistical ris...

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Bibliographic Details
Published in:	The journal of nervous and mental disease Vol. 197; no. 1; pp. 6 - 14
Main Authors:	Gearing, Robin Edward, Mian, Irfan, Sholonsky, Aron, Barber, Jim, Nicholas, David, Lewis, Ralph, Solomon, Leigh, Williams, Cheryl, Lightbody, Shawna, Steele, Margaret, Davidson, Brenda, Manchanda, Rahul, Joseph, Llewellyn, Handelman, Kenneth, Ickowicz, Abel
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-01-2009 Lippincott Williams & Wilkins Lippincott Williams & Wilkins Ovid Technologies
Subjects:	Adolescent Adult and adolescent clinical studies Biological and medical sciences Child Child clinical studies Children & youth Cohort Studies Female Humans Kaplan-Meier Estimate Male Medical sciences Medication Adherence Mental disorders Miscellaneous Models, Psychological Mood Disorders - psychology Patient admissions Patient Readmission - statistics & numerical data Prognosis Proportional Hazards Models Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Psychotic Disorders - psychology Psychotic Disorders - therapy Recurrence Retrospective Studies Risk Assessment - methods Risk Factors Schizophrenia Sex Factors Social Support Studies Canada North America America Human Social environment Mood disorder predictors Relapse adolescents mood disorders Mental health Schizophrenia Retrospective Psychosis first-episode School age Theoretical model First episode Adolescent Risk factor First apparition Predictive factor Child Public health
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Summary:	Individuals treated for psychotic disorders and mood disorders with psychotic features have a high likelihood of relapse across the life course. This study examines the relapse rate and its associated predictors for children and adolescents experiencing a first-episode and develops a statistical risk-model for prediction of time to first-relapse. A multiyear, retrospective cohort design was used to track youth, under the age of 18 years, who experienced a first-episode of psychosis, and were admitted to 1 of 6 inpatient hospital psychiatric units (N = 87). Participants were followed for at least 2 years (M = 3.9, SD = 1.3) using survival analysis. Approximately 60% of subjects experienced relapse requiring hospital readmission by the end of follow-up, with 33% readmitted within the first year and 44% within 2 years. Median survival time was 34 months. Cox proportional hazards regression identified 4 key risk factors for relapsemedication nonadherence, female gender, receiving clinical treatment, and a decline in social support before first admission.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-3018 1539-736X
DOI:	10.1097/NMD.0b013e31819251d8