Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The McLean First-Episode Psychosis project began in 1989. The authors describe the study design, diagnostic distribution, and recovery and relapse data on the first 102 recruited subjects. Fifty-nine percent of the subjects had a diagnosis of bipolar disorder, 15 percent psychotic depression, 10 percent schizophrenic spectrum, 9 percent delusional disorder, and 8 percent other psychotic disorders. By 6 months, 80 percent recovered syndromically but only 55 percent recovered functionally, and only 50 percent recovered both functionally and syndromically. Non-white and male patients were more likely to have a recurrence. Men were less likely and bipolar patients were more likely to recover functionally. Patients with nonaffective psychosis had longer hospitalizations and lower rates of functional recovery 6 months after discharge.
 ...
PMID:The McLean First-Episode Psychosis Project: six-month recovery and recurrence outcome. 162 Oct 73

This study was undertaken in order to clarify the clinical characteristic features and surgical results of coronary artery bypass grafting (CABG) in patients over 65 years of age (group III, n = 43). These patients were compared with 2 other groups of patients, one aged between 50 and 59 years (group I, n = 88) and another aged between 60 and 64 years (group II, n = 54), with respect to mortality, morbidity and late survival. CABG was performed with the saphenous vein under cold K-Mg-cardioplegia with systemic hypothermia. The hospital mortality was 2.3, 3.7, and 4.7 per cent in groups I, II and III, respectively, although no operative mortality was noted in any group. The number of coronary artery lesions increased with age, however, the left ventricular ejection fraction was relatively better preserved in the aged patients than in the younger ones. The 5-year survival rates were 93.4, 95.1 and 96.9 per cent in groups I, II and III, respectively, with most of the late deaths occurring within a year after CABG in each group. In the aged patients, postoperative functional recovery was delayed in the liver and kidney, and postoperative psychosis was not infrequent. The results of this study, indicating a low operative mortality and satisfactory late survival rate, thus strongly support CABG for the aged. Nevertheless, the prevention of postoperative complications is also extremely important for reducing hospital mortality.
 ...
PMID:The characteristics of coronary artery revascularization in aged patients. 234 37

A representative sample of 227 first-contact schizophrenic patients (according to DSM-III) was followed up for 5 years. The psychiatric teams responsible for the treatment of the patients conducted detailed standardized interviews with the patients at entry and at the end of the first, second and fifth years. Changes in patients' clinical and functional outcome were analysed according to their living situation and social network. Positive changes in clinical state and functional ability were most prominent among patients who were living with their spouse. The social and functional outcome of men living with their parents was better than that of women in the same situation, while among patients living alone or with some other person the gender difference was reversed. Family environment can be of great importance to schizophrenic patients, supporting their clinical and functional recovery from psychosis. Patients living outside families--and men in particular--are at great risk of poor outcome, perhaps because they often lose their social contacts. In the treatment of such individuals a more active strategy of out-patient and rehabilitative care is therefore needed.
 ...
PMID:Living situation, social network and outcome in schizophrenia: a five-year prospective follow-up study. 942 43

Schizoaffective disorder is a relatively common illness with an uncertain relationship with bipolar disorder. The publication of DSM-III-R in 1987 operationalized the diagnosis of schizoaffective disorder, separating it from psychotic bipolar disorder by the presence of persistent psychosis in the absence of affective symptoms. Since that time, there have been few prospective outcome studies comparing schizoaffective and bipolar disorders. The authors recruited 27 hospitalized patients with schizoaffective disorder and compared their 12-month outcome to 27 sex-, age-, socioeconomic status- and race-matched hospitalized bipolar patients. The schizoaffective patients were significantly less likely to achieve syndromic recovery than the bipolar patients, although neither group achieved high rates of symptomatic or functional recovery. As expected, the schizoaffective patients were more likely to exhibit persistent psychosis, with or without affective symptoms, throughout the follow-up interval. These data provide clinical support of the predictive value of the DSM-III-R criteria for schizoaffective disorder in a naturalistic outcome setting.
 ...
PMID:Twelve-month outcome of patients with DSM-III-R schizoaffective disorder: comparisons to matched patients with bipolar disorder. 998 53

Significant symptomatic improvement after a first episode of psychosis is not matched by a similar improvement in functional outcome. Thus, increased attention has been given to psychological intervention, in particular cognitive cognitive-behavioural therapy (CBT), with the hope of enhancing functional recovery. Outcome trials of CBT for schizophrenia are few, in particular for the first episode, and have been occasionally criticised for their lack of significance compared with supportive therapies. We describe a modular CBT approach for those with a first episode of psychosis that addresses adaptation as well as both functional and symptomatic outcome and one that parallels the theoretical shift in CBT that has occurred in the last decade. Guidelines for integrating CBT into an early psychosis service are presented.
 ...
PMID:Implementing cognitive-behavioural therapy for first-episode psychosis. 1605 12

The DSM-IV criteria for mania require: a distinct period that represents a break from pre-morbid functioning, a duration of at least one week, elevated or irritable mood, at least three to four classical manic signs and symptoms and the absence of any physical factors. Although not specifically mentioned in the ICD-10 or the DSM-IV definitions, delusional, hallucinatory, even first-rank, psychotic experiences can occur in mania. Acute mania can be subdivided into classical pure mania, mania with mood-congruent or mood-incongruent psychosis, mixed state and rapid-cycling mania. One quarter to two thirds of all manic episodes are associated with delusions, while 13% to 40% are associated with hallucinations. Mixed episode is a complex syndrome which is difficult to diagnose, has the most prolonged duration of bipolar episodes and more frequent psychotic profile than pure mania with high suicidality and poor response to drugs. Mixed state mania has been well known since Kreapelin and listed in classification systems with criteria that include both a manic and a major depressive episode nearly every day for at least a one-week period. On the other hand, mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electro-convulsive therapy or light therapy) should not contribute toward a diagnosis of Bipolar I Disorder. Although, theoretically, mania is supposed to be resolved within 1-3 months even without treatment, psychiatric hospitalization is very common in especially severe cases due to functional impairment. Current treatments for mania aim to control the agitation, impulsivity, aggression and psychotic symptoms and to help patients regain their pre-morbid functionality. However, the clinical management of mania is challenging as most patients show syndromal remission but incomplete functional recovery after the first episode of mania.
 ...
PMID:Treatment of acute mania. 1636 86

Disability in life functioning is an important and poorly understood consequence of major depressive disorder (MDD). Mood symptoms do not account for the magnitude of disability resulting from MDD. Impairments in several domains of neurocognitive (NC) functioning have been shown to interfere with functionality in other psychiatric populations. These deficits, also present in MDD, may play a significant role in disability experienced by many with this disorder. The aim of this study was to examine the degree to which NC deficits, independent of affective and psychotic symptoms, explain functional outcome 6 months following hospitalization for a major depressive episode. Participants with an MDD diagnosis (N=48) received NC testing and symptom ratings while in the hospital. These procedures were repeated, along with functionality ratings, 6 months later. Six-month NC performance was strongly associated with functionality ratings after covariation for residual depression. Selected NC domains tested at baseline were predictive of functionality at 6 months. These data indicate that NC deficits, at least for some MDD sufferers, play an important role in functional recovery. New treatments, whether pharmacologic or rehabilitative, may be required to help affected patients accommodate neurocognitively based performance deficits at work, at home and in the community.
 ...
PMID:Neurocognitive deficits and disability in major depressive disorder. 1704 58

Longitudinal assessment of the course of major psychiatric disorders has been advanced by studies from onset, but only rarely have large numbers of patients with a range of psychotic and major affective disorders been studied simultaneously and systematically from illness-onset. The decade-long McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research has systematically followed-up large numbers of patients with DSM-IV bipolar or psychotic disorders from first-hospitalization. Major findings among patients with bipolar I disorder include: [a] full functional recovery from initial episodes was uncommon, and full symptomatic recovery, much slower than early syndromal recovery; [b] risks of relapse, recurrence, and switching were very high in the first two years; [c] most early morbidity was depressive-dysphoric, as reported in mid-course; [d] initial depression or mixed-states predicted more later depressive and overall morbidity, whereas initial mania or psychosis predicted later mania and a better prognosis; [e] based on within-subject modeling, most patients did not show progressive cycling over time, and illness-course was rather chaotic within and among patients; [f] treatment-latency or episode-counts were unassociated with responsiveness to long-term mood-stabilizing treatment; [g] very high rates of suicidal behavior and accidents occurred early; [h] early substance-use comorbidity associated with anxiety; [i] factor-analysis of prodromal symptoms predicted bipolar disorder much better than non-affective psychotic disorders. Project findings indicate that the course of bipolar I disorder is much less favorable than had been believed formerly, despite clinical treatment with modern mood-stabilizing and other treatments.
 ...
PMID:Longitudinal research on bipolar disorders. 1761 40

The two main goals of early intervention in psychotic disorders are to reduce the period of time between the onset of psychosis and the commencement of effective treatment, and to provide consistent and comprehensive care during the critical early years of illness. Effective care during the critical early years involves proactive engagement and initiation of drug and psychosocial treatments, aiming for maximal symptomatic and functional recovery and the prevention of relapse. Over the past 15 years, an increasing number of specialised or streamed treatment delivery systems for early psychosis have been established around the world. There is now evidence that these services can reduce the duration of untreated psychosis and produce better symptomatic and functional recovery. In addition, they are more cost-effective than standard models of mental health care for these patients. Fully fledged, specialised early intervention services should be established, with full integration with local communities, as well as enhanced primary care systems focused on young people.
 ...
PMID:Early intervention in psychotic disorders: detection and treatment of the first episode and the critical early stages. 1790 25

Remission is a realistic goal for patients with schizophrenia, and, if sustained remission without relapse can be achieved, then patients may attain functional recovery. With each relapse, recovery can be slowed and the course of illness worsened. The risk of self-harm and harm to others increases with each psychotic episode. The chance of relapse is decreased if pharmacotherapy continues uninterrupted, and one strategy to ensure continuous treatment is using long-acting injectable antipsychotic medications. Achieving remission of schizophrenia is clinically meaningful because, besides symptom control, remission allows for improved vocational and social functioning. Functional recovery without relapse allows patients to return to work, sustain interpersonal relationships, and lead more productive lives. Therefore, achieving the goals of remission and recovery is in the best interest not only of patients with schizophrenia but also of society.
 ...
PMID:Treatment strategies to prevent relapse and encourage remission. 1828 75


1 2 3 4 5 6 Next >>