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Prognostic value of affective symptomatology in first-admitted psychotic patients
* 1 , 2 , 2 , 2 , 2 , 2
1  RSMB- Algorta-Bizkaia, EHU/UPV University, Basque Country, Spain.
2  CIBERSAM, Department of Psychiatry. Araba University Hospital - Santiago, EHU/UPV, Vitoria-Gasteiz, Basque Country, Spain


Objective: to analyze the predictive value of affective symptomatology in a first psychotic episode sample followed up during three and five years, regarding to hospitalization, relapses, suicidal behaviour, working level, social activity and global functioning.

Method: 112 inpatients with a first psychotic episode were included in a longitudinal-prospective study followed up during three (N=91) and five-year (N=82). Assessments included the YMRS and HRDS-21, the GAF, the Strauss-Carpenter prognostic scale, the PANSS and the Phillips pre-morbid adjustment scale. We used descriptive and logistic analysis to determine the predictive factors associated to the number of relapses, hospitalizations and suicide attempts; depressive, manic, activation and dysphoric dimensions as covariables.

Results: 91.46% of relapses and 21% of suicide attempts at fifth year. The GAF discriminated among prognostic groups from the third year (p 0.020), with the poorest prognosis in the schizophrenia group, while bipolar disorders and the rest of the diagnoses achieved an intermediate prognosis. The Strauss-Carpenter scale, specifically working, social activity and global functioning items, discriminated among three diagnostic groups and between affective and non-affective psychosis (p<0.05); while schizophrenia scored the poorest outcome, bipolar disorder scored the highest. Depressive dimension was significantly associated with a lower number of relapses and hospitalizations (p= 0.045 and p= 0.012) and manic dimension with more relapses (p= 0.023).

Conclusion: The depressive dimension presents the best prognosis. On the contrary, the activation dimension, in general, gives a more favourable prognosis with regards to functionality (social) and unfavourable with respect to relapses. Finally, the manic dimension is associated with a worse evolution regarding relapses. Only the dysphoric dimension is not associated with syndromic and/or functional prognosis.

Keywords: prognostic, affective, dimension, first psychosis