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Meta-Analysis
. 2021 Nov 3;64(1):e69.
doi: 10.1192/j.eurpsy.2021.2246.

Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis

Ana Catalan  1   2 , Anja Richter  2 , Gonzalo Salazar de Pablo  3   4 , Julio Vaquerizo-Serrano  3   5 , Gonzalo Mancebo  6 , Borja Pedruzo  6 , Claudia Aymerich  6 , Marco Solmi  4   7   8   9 , Miguel Á González-Torres  1 , Patxi Gil  10 , Philip McGuire  2   11   12 , Paolo Fusar-Poli  4   11   12   13
Affiliations
Meta-Analysis

Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis

Ana Catalan et al. Eur Psychiatry. .

Abstract

Background: To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP).

Methods: A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies.

Results: One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49-58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27-36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found.

Conclusions: Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.

Keywords: First-episode psychosis; predictors; psychosis; recovery; remission.

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Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flowchart outlining the study selection process.
Figure 2.
Figure 2.
Meta-analytic symptomatic remission and recovery proportion in first-episode of psychosis (FEP) over time.
See this image and copyright information in PMC

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