The peculiarities of remission forming after the first episode of psychosis in fertile age women
Grodno State Medical University, Grodno, Republic of Belarus
Vestnik VGMU. 2019;18(6):68-76.
Objectives. To determine the peculiarities of the remission formation after the first episode of psychosis (FEP) in childbearing age women, taking into account their menstrual function.
Material and methods. The study included 55 patients aged 18-35 years who were observed within 1 year after FEP. Socio-demographic, clinical and psychopathological characteristics, follow-up data were evaluated in the study. Clinical scales SAPS and SANS were used to determine the severity of positive and negative symptoms. In the follow-up (12 months period), the presence of rehospitalizations, the undergoing of supportive treatment and side effects, the presence of menstrual irregularities were evaluated, as well as the level of social functioning determined by using the «Scale for assessing the functioning of patients in various social fields».
Results. The achievement of symptoms reduction necessary for qualification of clinical remission was observed in 33 (60%) patients after one month of treatment. Rehospitalizations within 12 months after FEP were observed in 28 (50.9%) women. The number of patients with functional and clinical remission for more than 1 year made up 20 (36.4%) people. A positive association was found between the duration of untreated period and rehospitalization during 12 months (r=0.325, p=0.015). The duration of remission was positively associated with better indices of functioning in various social spheres: labor (r=0.380, p˂0.004), interpersonal relationships (r=0.430, p˂0.001), everyday life (r=0.352, p˂0.008). No effect of menstrual irregularities on rehospitalization (OR=1.94, 95% CI: 0.59; 6.4) in childbearing age women in the first year after FEP was revealed.
Conclusions. On FEP, the selection of antipsychotic medication for childbearing age women with a normal menstrual cycle must primarily be based on the clinical syndrome and the effectiveness of the drug for this patient, as well as the compliance.
Key words: first episode of psychosis, women, menstrual irregularities, remission, level of functioning, prospective study.
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Information about authors:
Yankouskaya A.H. – senior lecturer of the Chair of Psychiatry and Narcology, Grodno State Medical University.