Predictors of favourable outcome in young people with a first episode psychosis without antipsychotic medication


Data from the literature suggests that some first episode psychosis (FEP) patients may recover without antipsychotic medication. There is however no reliable way to identify them. In a previous paper we found, in a cohort of 584 FEP patients, that those consistently refusing medication had poorer pre-morbid functioning, less insight, higher rate of substance use and poorer outcome. However, some medication refusers, had a favourable outcome. The study aim was to identify predictors of good short term outcome despite non-exposure to medication.

The Early Psychosis Prevention and Intervention Centre (EPPIC) admitted 786 FEP patients between 1998 and 2000. Data were collected from patients’ files using a standardized questionnaire. Data on medication adherence was available in 584 patients. Among the 17.9% of patients who consistently refused medication over the entire treatment phase we compared patients who had a favourable symptomatic and functional outcome with those who did not.

Among patients who consistently refused medication, 41% achieved symptomatic remission and 33% reached functional recovery. Predictors of symptomatic remission were a better premorbid functioning level, higher education and employment status at baseline. Predictors of functional recovery were a shorter duration of the prodrome phase, less severe psychopathology at baseline and lower cannabis use.

Despite limitations mainly linked to the fact that non-exposure to antipsychotic medication was based on patient’s treatment refusal, this study identified some characteristics which may contribute to the identification of a sub-group of FEP patients who may have good short term outcome without antipsychotic treatment. (Full article)


I would be interested in finding out how they measure the duration of prodromal phase.

It would be nice if they started to focus more research on finding a cure rather than diddling with statistics all day long.
who cares

Absolutely They are never too close to Cure …!!! I think They should hurry now time has come to see the concrete development …!!

My first psychotic episode escaped unnoticed …!!! If i was given medication at that particular time !!
I could have saved my memory destruction .!!! I almost have all the negative symptoms including cognitive …!!! Never take chances with life …!!! Inform ur senior as soon as u have period …!!! Message to all … Love U…!!

If you stopped being so negative.


I understand Meghilla s frustration and I cut him a lot of slack. He was even feeling suicidal yesterday… he like many of us wants more conclusive research about curing schizophrenia. But learning how to predict the outcome and even prevent the onset are noble pursuits as well…

1 Like

When I was 17 I was hospitalised with psychosis. They didn’t want to diagnose me with sz then but they came close but my drugs councillor stopped them as he blamed the drugs I took.

I was on meds for about 6 months, then I stopped them completely on my own. It took 6 years for something stressful enough to trigger another episode to happen and then I got diagnosed. Now it seems to happen a lot.

Not sure this study would have picked up this type of thing. I would have probably been counted as recovered without meds, but now I get frustrated as I keep thinking I can come off them like I did before but I now always end up in hospital when that happens.

Really sucks.

It’s just so hard when someone is so consistently negative about the the things you post, and offers little in the way of constructive comment.

1 Like

I just think that scientists should focus al of their efforts on finding a cure and fix this dreadful illness.
It’s not right that we have to Iive with this. I’m glad they’re doing research on first episode psychosis Firemonkey but this is just insane. Give us something, a new med even that doesn’t ruin our body’s and our minds.

Most of this research is BS anyway. I had my first episode 15 years ago. Got treated promptly and then stopped the meds at the doctors behest. I went 7 years without having another episode. Does that make me recovered? How about the fact that I’ve had 5 subsequent episodes since then that seem to be getting worse? They need to look at the entire course of the patients life. It’s simply impossible to predict.


Are they testing 17 year old kids?

They don’t got it yet.

Drug use and gradual decline does it.

MortimerMouse was right, psychology doesn’t have the answers, medicine does.

ETA: Psychology has its place in recovery of individuals whose medication works.

1 Like

its the cannibus daze, the wisdom weed that all the kids are smoking these days to make them see straight. It can’t go on for long

1 Like