Objective:

Understanding prognosis is critical to anticipating public health needs and providing care to individuals with psychotic disorders. However, the long-term course of remission and recovery remains unclear. In this study, the most common trajectories of illness course are described for a cohort of individuals followed for 25 years since first admission for psychosis.

Methods:

Participants are from the Suffolk County Mental Health Project, an epidemiological study of first-admission psychosis. Data for the present study was collected from six follow-ups, with 311 individuals assessed at the 25-year follow-up. Common patterns of remission and recovery were assessed in the baseline cohort of 591 individuals and the subsample from the 25-year follow up.

Results:

In the baseline cohort and the 25-year subsample, the most common trajectory for individuals with schizophrenia spectrum disorders was no remission and no recovery. Among individuals with other psychotic disorders, in both the baseline and 25-year cohorts, the modal pattern was one of intermittent remission and recovery. Individuals with other psychotic disorders were more likely to experience stable remission (15.1%) and stable recovery (21.1%), outcomes that were rare among individuals with schizophrenia spectrum disorders (0% and 0.6%, respectively).

Conclusions:

The modal longitudinal pattern for individuals with other psychoses is one of multiple transitions into and out of symptomatic and functional recovery. Engagement in a long-term health care plan may help individuals detect and respond to these changes. Sustained remission and recovery are rare among people with schizophrenia spectrum disorders. Efforts should be directed toward developing more effective treatments for this population.

中文翻译：

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精神障碍的长期缓解和恢复过程

客观的：

了解预后对于预测公共卫生需求和为精神障碍患者提供护理至关重要。然而，缓解和恢复的长期过程仍不清楚。在这项研究中，描述了一组自首次因精神病入院以来跟踪了 25 年的个体最常见的病程轨迹。

方法：

参与者来自萨福克县心理健康项目，这是一项针对首次入院精神病的流行病学研究。本研究的数据是从 6 次随访中收集的，在 25 年的随访中对 311 人进行了评估。在 591 名个体的基线队列和 25 年随访的子样本中评估了常见的缓解和恢复模式。

结果：

在基线队列和 25 年子样本中，精神分裂症谱系障碍患者最常见的轨迹是没有缓解，也没有恢复。在患有其他精神障碍的个体中，在基线和 25 年队列中，最模式是间歇性缓解和恢复之一。患有其他精神障碍的个体更有可能经历稳定缓解（15.1%）和稳定恢复（21.1%），这在精神分裂症谱系障碍患者中罕见（分别为 0% 和 0.6%）。

结论：

患有其他精神病的个体的模态纵向模式是症状和功能恢复的多次转变之一。参与长期医疗保健计划可能有助于个人发现并应对这些变化。在精神分裂症谱系障碍患者中，持续缓解和恢复是罕见的。应努力为这一人群开发更有效的治疗方法。