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Published Online: 16 November 2015
Early Predictors of Ten-Year Course in First-Episode Psychosis
Svein Friis, M.D., Ph.D., Ingrid Melle, M.D., Ph.D., Jan Olav Johannessen, M.D., Ph.D., Jan Ivar Røssberg, M.D., Ph.D., Helene Eidsmo Barder, Ph.D., Julie Horgen Evensen, M.D., Ph.D., Ulrik Haahr, M.D., … Show All … , Wenche ten Velden Hegelstad, M.Sc., Ph.D., Inge Joa, Ph.D., Johannes Langeveld, Ph.D., Tor Ketil Larsen, M.D., Ph.D., Stein Opjordsmoen, M.D., Ph.D., Bjørn Rishovd Rund, Ph.D., Erik Simonsen, M.D. Ph.D., Per Wiggen Vaglum, M.D., Ph.D., and Thomas H. McGlashan, M.D. Show FewerAuthors Info & Affiliations
Abstract
Objective:
Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first psychotic episode.
Methods:
Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area–based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses.
Results:
Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow-up: deterioration in premorbid social functioning, duration of untreated psychosis (DUP) of ≥26 weeks, core schizophrenia spectrum disorder, and no remission within three months.
Conclusions:
First-episode psychosis patients should be followed carefully after the start of treatment. If symptoms do not remit within three months with adequate treatment, there is a considerable risk of a poor long-term outcome, particularly for patients with a deterioration in premorbid social functioning, a DUP of at least half a year, and a diagnosis within the core schizophrenia spectrum.
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Cover: Fame Weathervane, by E.G. Washburne and Company, circa 1890. Copper and zinc with gold leaf. American Folk Art Museum, Long Island City, New York. Gift of Ralph Esmerian, accession number 2005.8.62. Photo credit: Gavin Ashworth.
History
Received: 10 December 2014
Revision received: 1 June 2015
Accepted: 15 July 2015
Published online: 16 November 2015
Published in print: April 01, 2016
Authors
Details
Svein Friis, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Ingrid Melle, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Jan Olav Johannessen, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Jan Ivar Røssberg, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Helene Eidsmo Barder, Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Julie Horgen Evensen, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Ulrik Haahr, M.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Wenche ten Velden Hegelstad, M.Sc., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Inge Joa, Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Johannes Langeveld, Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Tor Ketil Larsen, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Stein Opjordsmoen, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Bjørn Rishovd Rund, Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Erik Simonsen, M.D. Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Per Wiggen Vaglum, M.D., Ph.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Thomas H. McGlashan, M.D.
Dr. Friis, Dr. Melle, and Dr. Røssberg are with the Division of Mental Health and Addiction, and Dr. Barder is with the Women and Children’s Division, all at Oslo University Hospital, Oslo, Norway (e-mail: [email protected]). Dr. Friis, Dr. Melle, and Dr. Røssberg are also with the Institute of Clinical Medicine, University of Oslo, where Dr. Evensen and Dr. Opjordsmoen are affiliated. Dr. Evensen is also with the Adult Psychiatric Department Vinderen, Diakonhjemmet Hospitals, Oslo. Dr. Johannessen, Dr. ten Velden Hegelstad, Dr. Joa, Dr. Langeveld, and Dr. Larsen are with the Division of Psychiatry, Network of Clinical Psychosis Research, Stavanger University Hospital, Stavanger, Norway. Dr. Johannessen and Dr. Joa are also with the Faculty of Social Sciences, University of Stavanger. Dr. Larsen is also with the Psychiatry Section, Department of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Haahr is with the Early Psychosis Intervention Center, Psychiatry East–Region Zealand, Roskilde, Denmark. Dr. Haahr is also with the Faculty of Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Denmark, where Dr. Simonsen is affiliated. Dr. Simonsen is also with the Psychiatric Research Unit, Region Zealand, Roskilde, Denmark. Dr. Rund is with the Department of Psychology, University of Oslo, and with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo. Dr. McGlashan is with the Department of Social and Behavioral Health, Yale School of Medicine, Yale University, New Haven, Connecticut.
Notes
Findings were presented at the national TIPS (Early Treatment and Intervention in First-Episode Psychosis) conference, Stavanger, Norway, November 3–4, 2014.
Competing Interests
Dr. Opjordsmoen has served as an advisor to or lectured at meetings organized by Lundbeck and Otsuka. The other authors report no financial relationships with commercial interests.
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