{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T04:08:56Z","timestamp":1785557336172,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate morbidity during long\u2010term follow\u2010up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major psychotic episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We followed adult subjects systematically at regular intervals from hospitalization for first\u2010lifetime episodes of major affective and schizoaffective disorders with initial psychotic features. We compiled % of days with morbidity types from detailed records and life charts, reviewed earliest antecedent morbidities, compared both with final diagnoses and initial presenting illness types, and evaluated morbidity risk factors with regression modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      With final diagnoses of bipolar\u2010I (BD\u2010I, n\u00a0=\u00a0216), schizoaffective (SzAffD, 71), and major depressive (MDD, 42) disorders, 329 subjects were followed for 4.47 [CI: 4.20\u20134.47] years. Initial episodes were mania (41.6%), mixed states (24.3%), depression (19.5%), or apparent nonaffective psychosis (14.6%). Antecedent morbidity presented 12.7\u00a0years before first episodes (ages: SzAffD\u00a0\u2264\u00a0BD\u2010I\u00a0&lt;\u00a0MDD). Long\u2010term % of days ill ranked SzAffD (83.0%), MDD (57.8%), BD\u2010I (45.0%). Morbidity differed by diagnosis and first\u2010episode types, and was predicted by first episodes and suggested by antecedent illnesses. Long\u2010term\n                      <jats:italic>wellness<\/jats:italic>\n                      was greater with BD\u2010I diagnosis, first episode not mixed or psychotic nonaffective, rapid onset, and being older at first antecedents, but not follow\u2010up duration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Initially, psychotic BD\u2010I, SzAffD, or MDD subjects followed for 4.47\u00a0years from first hospitalization experienced much illness, especially depressive or dysthymic, despite ongoing clinical treatment. Antecedent symptoms arose years before index first episodes; antecedents and first episode types predicted types and amounts of long\u2010term morbidity, which ranked: SzAffD\u00a0&gt;\u00a0MDD &gt; BD\u2010I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13243","type":"journal-article","created":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T03:33:42Z","timestamp":1602473622000},"page":"50-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long\u2010term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes"],"prefix":"10.1111","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-8352","authenticated-orcid":false,"given":"Paola","family":"Salvatore","sequence":"first","affiliation":[{"name":"International Consortium for Mood &amp; Psychotic Disorders Mailman Research Center McLean Hospital Belmont MA 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