Developing a risk-model of time to first-relapse for children and adolescents with a psychotic disorder

Abstract

Individuals treated for psychotic disorders and mood disorders with psychotic features have a high likelihood of relapse across the life course. This study examines the relapse rate and its associated predictors for children and adolescents experiencing a first-episode and develops a statistical risk-model for prediction of time to first-relapse. A multiyear, retrospective cohort design was used to track youth, under the age of 18 years, who experienced a first-episode of psychosis, and were admitted to 1 of 6 inpatient hospital psychiatric units (N = 87). Participants were followed for at least 2 years (M = 3.9, SD = 1.3) using survival analysis. Approximately 60% of subjects experienced relapse requiring hospital readmission by the end of follow-up, with 33% readmitted within the first year and 44% within 2 years. Median survival time was 34 months. Cox proportional hazards regression identified 4 key risk factors for relapse: medication nonadherence, female gender, receiving clinical treatment, and a decline in social support before first admission.