{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:56:03Z","timestamp":1789174563136,"version":"build-2803163510"},"reference-count":113,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"unspecified","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100016120","name":"Departamento de Salud, Gobierno de Navarra","doi-asserted-by":"publisher","award":["41\/18"],"award-info":[{"award-number":["41\/18"]}],"id":[{"id":"10.13039\/501100016120","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0033291724003465_sec1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Few studies have examined the long-term outcomes of first-episode psychosis (FEP) among patients beyond symptomatic and functional remission. This study aimed to broaden the scope of outcome indicators by examining the relationships between 12 outcomes of FEP patients at 20.9\u00a0years after their initial diagnosis.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003465_sec2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>At follow-up, 220 out of 550 original patients underwent a new assessment. Twelve outcomes were assessed via semistructured interviews and complementary scales: symptom severity, functional impairment, personal recovery, social disadvantage, physical health, number of suicide attempts, number of episodes, current drug use, dose-years of antipsychotics (DYAps), cognitive impairment, motor abnormalities, and DSM-5 final diagnosis. The relationships between these outcome measures were investigated using Spearman\u2019s correlation analysis and exploratory factor analysis, while the specific connections between outcomes were ascertained using network analysis.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003465_sec3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>The outcomes were significantly correlated; specifically, symptom severity, functioning, and personal recovery showed the strongest correlations. Exploratory factor analysis of the 12 outcomes revealed two factors, with 11 of the 12 outcomes loading on the first factor. Network analysis revealed that symptom severity, functioning, social disadvantage, diagnosis, cognitive impairment, DYAps, and number of episodes were the most interconnected outcomes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0033291724003465_sec4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusion<\/jats:title>\n\t    <jats:p>Network analysis provided new insights into the heterogeneity between outcomes among patients with FEP. By considering outcomes beyond symptom severity, the rich net of interconnections elucidated herein can facilitate the development of interventions that target potentially modifiable outcomes and generalize their impact on the most interconnected outcomes.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0033291724003465","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T22:39:51Z","timestamp":1738795191000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Multidimensional outcome of first-episode psychosis: a network analysis"],"prefix":"10.1017","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0250-5718","authenticated-orcid":false,"given":"Manuel J","family":"Cuesta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo J","family":"Gil-Berrozpe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-2406","authenticated-orcid":false,"given":"Ana M","family":"S\u00e1nchez-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Moreno-Izco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Garc\u00eda de Jal\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"Peralta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SEGPEPs Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"S0033291724003465_r65","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbr026"},{"key":"S0033291724003465_r11","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2024.5"},{"key":"S0033291724003465_r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.03.028"},{"key":"S0033291724003465_r49","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-198604000-00005"},{"key":"S0033291724003465_r45","article-title":"Revising axis V for DSM-IV: A review of measures of social functioning","volume":"149","author":"Goldman","year":"1992","journal-title":"American Journal of Psychiatry"},{"key":"S0033291724003465_r75","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2010.61.1.25"},{"key":"S0033291724003465_r113","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15110"},{"key":"S0033291724003465_r102","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-019-01766-y"},{"key":"S0033291724003465_r91","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbac053"},{"key":"S0033291724003465_r63","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2013.10.006"},{"key":"S0033291724003465_r86","article-title":"Social exclusion as a major outcome domain of psychotic disorders: Early predictors, and associations with non-recovery and clinical staging 21 years after a first episode of psychosis","author":"Peralta","year":"2024","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"S0033291724003465_r13","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.6.1018"},{"key":"S0033291724003465_r94","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.005012012"},{"key":"S0033291724003465_r35","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-021-01354-9"},{"key":"S0033291724003465_r55","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2012.06.008"},{"key":"S0033291724003465_r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.06.017"},{"key":"S0033291724003465_r108","volume-title":"Recovery from schizophrenia: Psychiatry and political economy","author":"Warner","year":"1994"},{"key":"S0033291724003465_r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2009.08.040"},{"key":"S0033291724003465_r76","doi-asserted-by":"publisher","DOI":"10.1177\/0004867420954268"},{"key":"S0033291724003465_r31","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-017-0862-1"},{"key":"S0033291724003465_r78","doi-asserted-by":"publisher","DOI":"10.1177\/0004867419827648"},{"key":"S0033291724003465_r32","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-023-02213-5"},{"key":"S0033291724003465_r68","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1276511"},{"key":"S0033291724003465_r44","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(23)00156-6"},{"key":"S0033291724003465_r88","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2007.09.012"},{"key":"S0033291724003465_r92","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab063"},{"key":"S0033291724003465_r112","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113724"},{"key":"S0033291724003465_r99","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-023-02298-3"},{"key":"S0033291724003465_r51","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbs118"},{"key":"S0033291724003465_r37","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2013.06.001"},{"key":"S0033291724003465_r7","doi-asserted-by":"publisher","DOI":"10.1037\/h0095655"},{"key":"S0033291724003465_r85","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbab145"},{"key":"S0033291724003465_r40","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30050-6"},{"key":"S0033291724003465_r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2020.01.007"},{"key":"S0033291724003465_r111","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbn143"},{"key":"S0033291724003465_r71","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.110.083733"},{"key":"S0033291724003465_r84","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.643112"},{"key":"S0033291724003465_r106","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.15111419"},{"key":"S0033291724003465_r89","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(02)00159-7"},{"key":"S0033291724003465_r23","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720000343"},{"key":"S0033291724003465_r54","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.06.069"},{"key":"S0033291724003465_r41","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20700"},{"key":"S0033291724003465_r14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291716003366"},{"key":"S0033291724003465_r42","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2022.12.046"},{"key":"S0033291724003465_r73","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100227"},{"key":"S0033291724003465_r48","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-022-02256-7"},{"key":"S0033291724003465_r34","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbaa089"},{"key":"S0033291724003465_r52","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.7517"},{"key":"S0033291724003465_r30","doi-asserted-by":"publisher","DOI":"10.1007\/s11336-017-9557-x"},{"key":"S0033291724003465_r24","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114933"},{"key":"S0033291724003465_r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2017.08.050"},{"key":"S0033291724003465_r69","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2014.08.010"},{"key":"S0033291724003465_r110","doi-asserted-by":"publisher","DOI":"10.1017\/S146114570500516X"},{"key":"S0033291724003465_r20","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpmh.2023.11.002"},{"key":"S0033291724003465_r105","article-title":"The relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis","volume":"44","author":"Van Eck","year":"2018b","journal-title":"Schizophrenia Bullettin"},{"key":"S0033291724003465_r2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1468-y"},{"key":"S0033291724003465_r21","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.055137"},{"key":"S0033291724003465_r66","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbad023"},{"key":"S0033291724003465_r101","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2021.08.022"},{"key":"S0033291724003465_r70","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2014.04.011"},{"key":"S0033291724003465_r79","first-page":"1808","article-title":"Readmission of patients to acute psychiatric hospitals: Influential factors and interventions to reduce psychiatric readmission rates","volume":"10","author":"Owusu","year":"2022","journal-title":"Healthcare (Basel, Switzerland)"},{"key":"S0033291724003465_r16","doi-asserted-by":"publisher","DOI":"10.1038\/s43586-021-00055-w"},{"key":"S0033291724003465_r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.05.023"},{"key":"S0033291724003465_r103","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20230189"},{"key":"S0033291724003465_r50","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2021.0015"},{"key":"S0033291724003465_r5","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820080023004"},{"key":"S0033291724003465_r74","doi-asserted-by":"publisher","DOI":"10.1016\/0740-5472(92)90062-S"},{"key":"S0033291724003465_r29","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-13-50"},{"key":"S0033291724003465_r80","first-page":"PCC.09m00799","article-title":"The effect of antipsychotic medication on neuromotor abnormalities in neuroleptic-naive nonaffective psychotic patients: A naturalistic study with haloperidol, risperidone, or olanzapine","volume":"12","author":"Peralta","year":"2010","journal-title":"Primary Care Companion to the Journal of Clinical Psychiatry"},{"key":"S0033291724003465_r77","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2022.152307"},{"key":"S0033291724003465_r72","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.11.074"},{"key":"S0033291724003465_r87","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2021.11.027"},{"key":"S0033291724003465_r1","article-title":"Self-reported reasons for discontinuation or continuation of antipsychotic medication in individuals with first-episode schizophrenia","volume":"17","author":"Ae","year":"2023","journal-title":"Early Intervention in Psychiatry"},{"key":"S0033291724003465_r100","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21121"},{"key":"S0033291724003465_r53","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.5164"},{"key":"S0033291724003465_r64","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbad035"},{"key":"S0033291724003465_r96","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.114383"},{"key":"S0033291724003465_r10","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.5.672"},{"key":"S0033291724003465_r38","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(21)00121-8"},{"key":"S0033291724003465_r97","article-title":"Diagnosis and management of the metabolic syndrome: An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement","volume":"112","author":"Sm","year":"2005","journal-title":"Circulation"},{"key":"S0033291724003465_r36","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-024-01782-3"},{"key":"S0033291724003465_r93","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00363-6"},{"key":"S0033291724003465_r46","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx082"},{"key":"S0033291724003465_r26","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(00)00003-7"},{"key":"S0033291724003465_r90","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.117.205492"},{"key":"S0033291724003465_r56","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1176\/ajp.151.10.1409","article-title":"One hundred years of schizophrenia: A meta-analysis of the outcome literature","volume":"151","author":"Hegarty","year":"1994","journal-title":"The American Journal of Psychiatry"},{"key":"S0033291724003465_r4","volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013"},{"key":"S0033291724003465_r3","first-page":"22","article-title":"The association between psychosocial stress, interpersonal sensitivity, social withdrawal and psychosis relapse: A systematic review","volume":"9","author":"Almuqrin","year":"2023","journal-title":"Schizophrenia (Heidelberg, Germany)"},{"key":"S0033291724003465_r104","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx088"},{"key":"S0033291724003465_r15","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20375"},{"key":"S0033291724003465_r59","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20822"},{"key":"S0033291724003465_r18","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-020-01500-6"},{"key":"S0033291724003465_r58","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.114211"},{"key":"S0033291724003465_r81","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx089"},{"key":"S0033291724003465_r43","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2022.2092402"},{"key":"S0033291724003465_r47","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20624"},{"key":"S0033291724003465_r28","doi-asserted-by":"publisher","DOI":"10.1037\/a0014415"},{"key":"S0033291724003465_r33","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2024.102459"},{"key":"S0033291724003465_r62","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2172"},{"key":"S0033291724003465_r9","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717003774"},{"key":"S0033291724003465_r95","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1970.tb02066.x"},{"key":"S0033291724003465_r98","doi-asserted-by":"publisher","DOI":"10.1177\/00207640221137993"},{"key":"S0033291724003465_r57","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"S0033291724003465_r109","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e32832c920b"},{"key":"S0033291724003465_r60","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2017.06.004"},{"key":"S0033291724003465_r61","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.10.085"},{"key":"S0033291724003465_r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.09.022"},{"key":"S0033291724003465_r83","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.008"},{"key":"S0033291724003465_r82","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbx089"},{"key":"S0033291724003465_r107","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1781(97)00114-5"},{"key":"S0033291724003465_r67","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(02)00310-9"},{"key":"S0033291724003465_r19","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20994"},{"key":"S0033291724003465_r12","article-title":"On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis","author":"Benrimoh","year":"2024","journal-title":"Molecular Psychiatry"}],"updated-by":[{"DOI":"10.1017\/s0033291725101098","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000}}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291724003465","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T07:40:49Z","timestamp":1753947649000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291724003465\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":113,"alternative-id":["S0033291724003465"],"URL":"https:\/\/doi.org\/10.1017\/s0033291724003465","relation":{"correction":[{"id-type":"doi","id":"10.1017\/S0033291725101098","asserted-by":"object"}]},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e29"}}