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

Marwaha, Steven, Hett, Danielle, Johnson, Sonia, Fowler, David, Hodgekins, Joanne, Freemantle, Nick, McCrone, Paul, Everard, Linda, Jones, Peter, Amos, Tim, Singh, Swaran, Sharma, Vimal and Birchwood, Max (2021) The impact of manic symptoms in first-episode psychosis: findings from the UK National EDEN study. Acta Psychiatrica Scandinavica. ISSN 0001-690X

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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 the following: (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.

Item Type: Article
Schools and Departments: School of Psychology > Psychology
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 15 Apr 2021 15:36
Last Modified: 13 May 2021 13:00
URI: http://sro.sussex.ac.uk/id/eprint/98462

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