Predictors of Relapse and Functioning in First-Episode Psychosis: A Two-Year Follow-Up Study
Abstract
OBJECTIVE: First-episode psychosis has an annual incidence rate of 24.6 to 40.9 per 100,000 population, and most individuals develop chronic disorders, such as schizophrenia or affective psychosis. The first two to five years are thought to be key determinants of long-term functional and clinical prognosis. This study aimed to determine the two-year course of illness in first-episode psychosis, including diagnosis, relapse, and functioning and factors related to these variables. METHODS: A total of 140 patients who experienced a first episode of psychosis were recruited and evaluated between 2008 and 2012 in a first-episode psychosis program in Barcelona, Spain. Regression models were used to determine factors predicting relapse and functioning. RESULTS: A general trend was noted toward improved functioning and less severe psychotic symptoms. However, after two years, one-third of the patients had a diagnosis of schizophrenia and more than 40% had a diagnosis of affective psychosis. Rates of relapse were 31% after one year and 43% at two years. Cannabis use after illness onset and poor insight were the best predictors of relapse. Being male and severity of negative symptoms at baseline predicted worse functioning at two years. CONCLUSIONS: Patients with first-episode psychosis were found to have high relapse rates during the first years after illness onset. Further studies evaluating treatment strategies focused on reducing cannabis use and improving insight in first-episode psychosis should be encouraged.
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Impairments in social functioning have been associated with positive symptoms of psychosis, increased levels of risk and self-harm, increased risk of relapse, delayed return to employment and re-engagement with previously held social roles.
“Impairments in social functioning have been associated with positive symptoms of psychosis, increased levels of risk and self‐harm and increased risk of relapse, as well as a delayed return to employment and re‐engagement with previously held social roles (Bae et al. 2010; Bergé et al. 2016; Carrión et al. 2021; Kim et al. 2019; Oorschot et al. 2012; Velthorst et al. 2017).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Bergé et al. 2016
Better insight predicts reduced risk of relapse and improvement in positive and negative symptoms.
“Evidence that insight influences symptoms includes findings that better insight predicts reduced risk of relapse 54 and improvement in positive and negative symptoms 55 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [54]
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Motives for Substance Use Among Male Psychiatric Inpatients with Psychotic Disorders
Ţăpoi, C., & Ogamdi, E. C. (2026) · Psychiatry International · doi:10.3390/psychiatryint7030120
- Authors
- Bergé, D., Mané, A., Salgado, P., Cortizo, R., Garnier, C., Gomez, L., Diez-Aja, C., Bulbena, A., & Pérez, V.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- The authors are with the Department of Neurosciences and Psychiatry, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain (e-mail: ). Dr. Bergé, Dr. Mané, and Dr. Pérez are also with Centro de Investigación Biomédica en Red en Salud Mental, Barcelona. Dr. Bulbena is also with the Department of Psychiatry, Universitat Autonoma de Barcelona, Barcelona.
- Venue
- Psychiatric Services
- Published
- 2016-02-01
- Volume
- 67
- Issue
- 2
- Pages
- 227-233
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W1910503145
- Cited by
- 96
- References
- 63
- Citations by year
- 2026: 2 · 2025: 13 · 2024: 8 · 2023: 11 · 2022: 15 · 2021: 10 · 2020: 11 · 2019: 7 · 2018: 7 · 2017: 6 · 2016: 5 · 2014: 1
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- first-episode psychosis, relapse, functional outcome, schizophrenia, affective psychosis, cannabis use, insight, negative symptoms, prognosis, clinical course, predictors of relapse
- MeSH terms
- Adult, Affective Disorders, Psychotic, Female, Follow-Up Studies, Humans, Male, Marijuana Smoking, Prognosis, Psychotic Disorders, Recurrence, Risk Factors, Schizophrenia, Schizophrenic Psychology, Sex Factors, Spain, Time Factors, Proportional Hazards Models, Disease Progression, Recovery of Function, Young Adult
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