The McLean-Harvard first-episode project: 6-month symptomatic and functional outcome in affective and noneffective psychosis

Background: The McLean-Harvard First-Episode Project recruited affective an d nonaffective patients at their first lifetime psychiatric hospitalization . Methods: Baseline evaluation and 6-month follow-up in 257 cases yielded rec overy outcomes defined by syndromal (absence of DSM-IV criteria for a curre nt episode) and functional (vocational and residential status at least at b aseline levels) status, Time to recovery was assessed by survival analysis, and risk factors by multivariate logistic regression. Results: Syndromal recovery was attained by 77% of cases over an average of 84 days. By diagnostic group, syndromal recovery rates ranked (p = .001) m ajor affective disorders (81%) > nonaffective acute psychoses (74%) > schiz oaffective disorders (70%) > schizophrenia (36%). Functional recovery was s ignificantly associated to syndromal recovery, diagnosis, shorter hospitali zation normalized to year, and older age at onset. Average hospital stay de clined across the study period, but recovery did not vary with year of entr y. Conclusions: Syndromal recovery was achieved by nearly one half of patients within 3 months of a first lifetime hospitalization for a psychotic illnes s, but functional recovery was not achieved by 6 months in nearly two third s of patients who had attained syndromal recovery. (C) 2000 Society of Biol ogical Psychiatry.