{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:36:03Z","timestamp":1785436563005,"version":"3.56.0"},"reference-count":39,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125026105819_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Identifying patients with first-episode psychosis (FEP) who are unlikely to achieve early clinical recovery (ECR) is critical for personalised intervention and resource allocation. ECR \u2013 defined as the concurrent achievement of symptomatic and functional remission \u2013 represents a clinically meaningful outcome that captures both illness control and functional reintegration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105819_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To develop and externally validate prediction models for ECR using clinical, cognitive and genetic data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105819_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      We analysed two large, independent Spanish cohorts: the primeros episodios psic\u00f3ticos cohort (\n                      <jats:italic>N<\/jats:italic>\n                      = 335), for model development and internal validation, and the Programa Asistencial a las Fases Iniciales de Psicosis cohort (\n                      <jats:italic>N<\/jats:italic>\n                      = 668), for external validation. Forty-seven baseline clinical and cognitive variables and 87 polygenic risk scores (PRSs) were examined. Predictors were selected using penalised logistic regression. Logistic regression and three machine learning algorithms were compared for discrimination, calibration and clinical utility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105819_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The best-performing model was a logistic regression using six routinely collected clinical and cognitive predictors (duration of untreated psychosis, days of treated psychosis, baseline functioning, insight, executive function and cognitive reserve), with an optimism-corrected area under the receiver operating characteristic curve of 0.73 in development and 0.63 in external validation. PRS models showed limited external generalisability and did not improve prediction. Machine learning algorithms offered no advantage over regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026105819_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple, interpretable logistic regression model based on routine clinical and cognitive variables can predict early recovery in FEP with acceptable generalisability. These findings support the use of transparent, clinically grounded models in early psychosis care and highlight the current limitations of genetic predictors for individualised treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2026.10581","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T08:35:15Z","timestamp":1774254915000},"page":"1-12","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Predicting early clinical recovery in first-episode psychosis: development and external validation of a clinically interpretable multivariable model"],"prefix":"10.1192","author":[{"given":"Laura","family":"Juli\u00e0","sequence":"first","affiliation":[{"name":"Cl\u00ednic Foundation \u2013 August Pi i Sunyer Biomedical Research Institute (IDIBAPS)"},{"id":[{"id":"https:\/\/ror.org\/021018s57","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Ortiz-Garc\u00eda de la Foz","sequence":"additional","affiliation":[{"name":"Valdecilla Biomedical Research (IDIVAL)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c0lex","family":"Gonz\u00e1lez-Segura","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic of Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Alemany","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine of Seville (IBiS) \u2013 CSIC"},{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Lluis","family":"Carrasco","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/021018s57","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8538-3175","authenticated-orcid":false,"given":"Covadonga Martinez","family":"D\u00edaz-Caneja","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Institute of Psychiatry and Mental Health, Gregorio Mara\u00f1\u00f3n General University Hospital, IiSGM"},{"name":"Complutense University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Zorrilla","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"\u00c1lava University Hospital"},{"name":"University of the Basque Country (UPV\/EHU)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lobo","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Aragon Health Research Institute (IIS-A)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Hospital de la Santa Creu i Sant Pau, Sant Pau Biomedical Research Institute (IIB Sant Pau)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Ayesa-Arriola","sequence":"additional","affiliation":[{"name":"Valdecilla Biomedical Research (IDIVAL)"},{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Su\u00e1rez-Pinilla","sequence":"additional","affiliation":[{"name":"Valdecilla Biomedical Research (IDIVAL)"},{"name":"Marqu\u00e9s de Valdecilla University Hospital"},{"name":"University of Cantabria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Juncal-Ruiz","sequence":"additional","affiliation":[{"name":"Valdecilla Biomedical Research (IDIVAL)"},{"name":"Hospital Sierrallana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"G\u00f3mez-Revuelta","sequence":"additional","affiliation":[{"name":"Valdecilla Biomedical Research (IDIVAL)"},{"name":"Marqu\u00e9s de Valdecilla University Hospital"},{"name":"University of Cantabria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concepci\u00f3n","family":"de la C\u00e1mara","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Zaragoza Clinical University Hospital (HCU-Z)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Usall","sequence":"additional","affiliation":[{"name":"Sant Joan de D\u00e9u Research Institute, Sant Joan de D\u00e9u Healthcare Park"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Ram\u00f3n y Cajal University Hospital, University of Alcal\u00e1, Ram\u00f3n y Cajal Health Research Institute (IRYCIS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Romero-Lopez-Alberca","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"University of C\u00e1diz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Spuch","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Galicia Sur Health Research Institute (IIS-Galicia Sur), SERGAS-UVIGO"},{"name":"Addictions Primary Care Research Network (RIAPAD), ISCIII"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Man\u00e8","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"Sant Joan de D\u00e9u Research Institute, Sant Joan de D\u00e9u Healthcare Park"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gonz\u00e1lez-Pinto","sequence":"additional","affiliation":[{"name":"Network Centre for Biomedical Research in Mental Health (CIBERSAM), Carlos III Health Institute"},{"name":"\u00c1lava University 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","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 (https:\/\/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"}]}}