Long-term Course of Psychosis

Long-term Course of Psychosis

Long-term outcome studies are extremely informative in helping to identify risk factors for poor outcome and identify potential protective factors and therapeutic factors. They are difficult to study and maintain and a limited number of studies have been set up worldwide. Studies in an Asian context are particularly important to explore the contribution of factors unique to a non-western population.
The research findings can provide insights in determinants of the illness outcome, underlying mechanisms implicated in different courses of the illness (e.g. biological toxicity hypothesis of untreated psychosis), addressing as-yet unanswered research question of neuro-developmental versus neuro-degenerative hypotheses for psychosis, as well as development of effective interventions in improving patients’ prognosis.

Current/Developing projects:
  • 12-year naturalistic outcome of First-episode psychosis (FEP12 study)
    This study aimed to examine the 12-year clinical and functional outcomes of first-episode psychosis patients based on FEP3 cohort. This investigation will facilitate development of a prediction model for long-term illness outcome incorporating multiple domains including pre-morbid adjustment, socio-demographics, baseline clinical and cognitive parameters, and early illness outcome variables.

  • 5 Year follow up RCT comparing 2-year with 3-year of intensive intervention (EASY5 study)
    This naturalistic prospective study aims to follow up the EASY3 study cohort to examine whether the initial beneficial effects of 1-year extended case management on illness outcome can be sustained in 2-year period. This study will therefore provide important data addressing the current as-yet unknown clinical and research question on the optimal duration of early intervention for psychosis.

  • 10 Year case-controlled study comparing Early Intervention with a well-matched Historical Control
    This study compares the effects of early intervention program (EASY) and standard generic psychiatric are on clinical and functional outcomes in patients presenting with first-episode psychosis. The results showed that at 3 years, EASY was more superior than standard care in improving functioning, symptom severity, and reducing hospitalization and suicide rate. An extension study looked at 10 year outcomes, both clinical and functioning, of early intervention and standard service. Cost-effectiveness of the specialized intervention service will be evaluated.

  • Hong Kong Outcome of Psychosis Evaluation (HOPE) study
    This is a new prospective long-term first-onset psychosis study to test new hypotheses. The study prospectively examine the determinants of long-term clinical and functional outcomes of psychotic disorders in a large representative cohort of patients presenting with first-episode psychosis to EASY programs. The study will specifically focus on investigating predictors of relapse, treatment-resistance and persistent negative symptoms, as well as clarifying the illness trajectory of those less frequent diagnostic entities such as delusional disorder and acute psychosis. Alongside clinical, cognitive and functional assessments, genetic and neuroimaging components will also be incorporated to evaluate the neuro-developmental versus neuro-degenerative hypotheses of schizophrenia. This study is in collaboration with the EASY Team in Kwai Chung Hospital, Hong Kong.
Prof. Eric YH Chen (Lead)
Dr. WC Chang
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. Christy LM Hui
Dr. Simon SY Lui
Dr. YN Suen