Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study
Open accessAbstract
BACKGROUND: Studies of the long-term course and outcome of psychoses tend to focus on cohorts of prevalent cases. Such studies bias samples towards those with poor outcomes, which may distort our understanding of prognosis. Long-term follow-up studies of epidemiologically robust first-episode samples are rare. METHOD: AESOP-10 is a 10-year follow-up study of 557 individuals with a first episode of psychosis initially identified in two areas in the UK (South East London and Nottingham). Detailed information was collated on course and outcome in three domains (clinical, social and service use) from case records, informants and follow-up interviews. RESULTS: At follow-up, of 532 incident cases identified, at baseline 37 (7%) had died, 29 (6%) had emigrated and eight (2%) were excluded. Of the remaining 458, 412 (90%) were traced and some information on follow-up was collated for 387 (85%). Most cases (265, 77%) experienced at least one period of sustained remission; at follow-up, 141 (46%) had been symptom free for at least 2 years. A majority (208, 72%) of cases had been employed for less than 25% of the follow-up period. The median number of hospital admissions, including at first presentation, was 2 [interquartile range (IQR) 1-4]; a majority (299, 88%) were admitted a least once and a minority (21, 6%) had 10 or more admissions. Overall, outcomes were worse for those with a non-affective diagnosis, for men and for those from South East London. CONCLUSIONS: Sustained periods of symptom remission are usual following first presentation to mental health services for psychosis, including for those with a non-affective disorder; almost half recover.
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Underlying cause of death was further ascertained based on extensive information collated from clinical records at follow-up using an extended version of the WHO Life Chart.
“The underlying cause of death recorded on copies of death certificates was further ascertained based on extensive information collated from clinical records at follow-up using an extended version of the World Health Organization (WHO) Life Chart.28,30”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [28]
Attrition bias has been reported to be minimal for the 10-year follow-up period.
“for which attrition bias has been reported to be minimal for the 10-year follow-up period.28”
From Mortality in Schizophrenia and Other Psychoses: A 10-Year Follow-up of the ӔSOP First-Episode Cohort (2015) · cites this paper as [28]
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- Authors
- Morgan, C., Lappin, J., Heslin, M., Donoghue, K., Lomas, B., Reininghaus, U., Onyejiaka, A., Croudace, T., Jones, P. B., Murray, R. M., Fearon, P., Doody, G. A., & Dazzan, P.
- Affiliations
- King's College London (GB)
- University of Nottingham (GB)
- University of York (GB)
- University of Cambridge (GB)
- Trinity College Dublin (IE)
- Corresponding author
- Morgan, C.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-02-26
- Volume
- 44
- Issue
- 13
- Pages
- 2713-2726
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC4134320
- OpenAlex
- W2000164531
- Cited by
- 248
- References
- 36
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 25 · 2023: 23 · 2022: 26 · 2021: 25 · 2020: 26 · 2019: 21 · 2018: 30 · 2017: 17 · 2016: 17 · 2015: 9 · 2014: 5
- FWCI
- 12.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion)
- Funders
- National Institute for Health and Care Research (PDF-2011-04-065)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- first-episode psychosis, long-term outcomes, prognosis, symptom remission, sustained remission, employment, hospitalization, service utilization, social functioning, non-affective psychosis, sex differences, ethnic differences
- MeSH terms
- Adult, England, Female, Follow-Up Studies, Hospitalization, Humans, London, Male, Middle Aged, Psychotic Disorders, Sex Factors, Incidence, Disease Progression
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