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Unmet needs in patients with first-episode schizophrenia: a longitudinal perspective

Published online by Cambridge University Press:  21 November 2011

K. Landolt ,
W. Rössler ,
T. Burns ,
V. Ajdacic-Gross ,
S. Galderisi ,
J. Libiger ,
D. Naber ,
E. M. Derks ,
R. S. Kahn  and
W. W. Fleischhacker
K. Landolt*
Affiliation:
Department of General and Social Psychiatry, Zurich University Psychiatric Hospital, University of Zurich, Switzerland
W. Rössler
Affiliation:
Department of General and Social Psychiatry, Zurich University Psychiatric Hospital, University of Zurich, Switzerland Collegium Helveticum, Institute for Transdisciplinary Research of the Swiss Federal Institute of Technology and the University of Zurich, Switzerland
T. Burns
Affiliation:
Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
V. Ajdacic-Gross
Affiliation:
Department of General and Social Psychiatry, Zurich University Psychiatric Hospital, University of Zurich, Switzerland
S. Galderisi
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
J. Libiger
Affiliation:
Psychiatric Clinic, Faculty Hospital Hradec Králové, Charles University Medical School, Hradec Králové, Czech Republic
D. Naber
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
E. M. Derks
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center, Utrecht, The Netherlands
R. S. Kahn
Affiliation:
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center, Utrecht, The Netherlands
W. W. Fleischhacker
Affiliation:
Biological Psychiatry Division, Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
*
*Address for correspondence: K. Landolt, M.Sc., Research Unit for Clinical and Social Psychiatry, Psychiatric University Hospital, Militärstrasse 8/PO Box 1930, 8021 CH-Zurich, Switzerland. (Email: klandolt@dgsp.uzh.ch)
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Abstract

Background

This study aimed to identify the course of unmet needs by patients with a first episode of schizophrenia and to determine associated variables.

Method

We investigated baseline assessments in the European First Episode Schizophrenia Trial (EUFEST) and also follow-up interviews at 6 and 12 months. Latent class growth analysis was used to identify patient groups based on individual differences in the development of unmet needs. Multinomial logistic regression determined the predictors of group membership.

Results

Four classes were identified. Three differed in their baseline levels of unmet needs whereas the fourth had a marked decrease in such needs. Main predictors of class membership were prognosis and depression at baseline, and the quality of life and psychosocial intervention at follow-up. Depression at follow-up did not vary among classes.

Conclusions

We identified subtypes of patients with different courses of unmet needs. Prognosis of clinical improvement was a better predictor for the decline in unmet needs than was psychopathology. Needs concerning social relationships were particularly persistent in patients who remained high in their unmet needs and who lacked additional psychosocial treatment.

Keywords

First episodelongitudinal studiesneeds assessmentschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 7 , July 2012 , pp. 1461 - 1473
Copyright
Copyright © Cambridge University Press 2011

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