Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients

Franciska de Beer; Sanne Koops; Robert A. Schoevers; Wim Veling; Nico van Beveren; Lieuwe de Haan; Nynke Boonstra; Martijn Kikkert; Marieke J.H. Begemann; Inge van der Heijden; Joelle Hoornaar; Ellen Graveland; Jan Jaap Hage; Ruben Curfs; Albert Batalla Cases; Sybren Wiersma; Selene Veerman; Natalie Veen; Anton B.P. Staring; Gerdina Hendrika Maria Pijnenborg; Jörg Kurkamp; Henderikus Knegtering; Martijn de Jonge; Koen Grootens; Gunnar Faber; Truus van den Brink; Steven Berendsen; Maarten Bak; Therese van Amelsvoort; Toon Scheurink; Matej Djordjevic; Iris Hamers; Alban Voppel; Priscilla Oomen; Erna van’t Hag; Shiral Gangadin; Bodyl Brand; Joran Lokkerbol; P. Roberto Bakker; Sinan Gülöksüz; Bram Sieben Rosema; Machteld Marcelis; Sanne Schuite-Koops; Marieke Begemann; Filip Smit; Jim van Os; Iris Sommer; Iris E.C. Sommer; HAMLETT-OPHELIA Consortium

doi:10.1038/s41598-024-72678-4

Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients

Franciska de Beer^*, Sanne Koops, Robert A. Schoevers, Wim Veling, Nico van Beveren, Lieuwe de Haan, Nynke Boonstra, Martijn Kikkert, Marieke J.H. Begemann, Inge van der Heijden, Joelle Hoornaar, Ellen Graveland, Jan Jaap Hage, Ruben Curfs, Albert Batalla Cases, Sybren Wiersma, Selene Veerman, Natalie Veen, Anton B.P. Staring, Gerdina Hendrika Maria PijnenborgJörg Kurkamp, Henderikus Knegtering, Martijn de Jonge, Koen Grootens, Gunnar Faber, Truus van den Brink, Steven Berendsen, Maarten Bak, Therese van Amelsvoort, Toon Scheurink, Matej Djordjevic, Iris Hamers, Alban Voppel, Priscilla Oomen, Erna van’t Hag, Shiral Gangadin, Bodyl Brand, Joran Lokkerbol, P. Roberto Bakker, Sinan Gülöksüz, Bram Sieben Rosema, Machteld Marcelis, Sanne Schuite-Koops, Marieke Begemann, Filip Smit, Jim van Os, Iris Sommer, Iris E.C. Sommer, HAMLETT-OPHELIA Consortium

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Clinical outcomes after a first-episode of psychosis (FEP) are heterogeneous. Many patient-related factors such as gender and comorbidity have been studied to predict symptomatic outcomes. However, psychiatrist-related factors such as prescription behaviour and gender have received little attention. We assessed the relationship between patients’ psychiatrists, psychosis severity and daily functioning in 201 patients remitted from an FEP for a duration of one year, treated by 18 different psychiatrists. We controlled for baseline severity, dose and type of antipsychotic medication, frequency of visits, and patients’ education. Symptom severity, daily functioning, and antipsychotic drug use were assessed at baseline and at 3, 6, and, 12 months follow-up. We found that psychiatrists accounted for 9.1% of the explained variance in patients’ symptom severity and 10.1% of the explained variance in daily functioning.These effects persisted even when controlling for factors such as baseline severity and the prescribed dose. The effect of prescribed dose on symptom severity and daily functioning differed between psychiatrists. Treatment centre, session frequency, and medication nonadherence were not related to symptom severity. Our results emphasize the importance of individual psychiatrist factors in symptomatic outcomes after an FEP. Further identification of psychiatrist-related factors such as the quality of therapeutic alliances and shared decision-making, may optimize psychiatrists’ training with the goal of improving patient outcomes.

Original language	English
Article number	22871
Number of pages	11
Journal	Scientific Reports
Volume	14
Issue number	1
DOIs	https://doi.org/10.1038/s41598-024-72678-4
Publication status	Published - 1 Dec 2024

Keywords

Antipsychotic agents
Psychiatrists
Psychotic disorders
Severity of illness
Treatment outcome

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de Beer, F., Koops, S., Schoevers, R. A., Veling, W., van Beveren, N., de Haan, L., Boonstra, N., Kikkert, M., Begemann, M. J. H., van der Heijden, I., Hoornaar, J., Graveland, E., Hage, J. J., Curfs, R., Cases, A. B., Wiersma, S., Veerman, S., Veen, N., Staring, A. B. P., ... HAMLETT-OPHELIA Consortium (2024). Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients. Scientific Reports, 14(1), Article 22871. https://doi.org/10.1038/s41598-024-72678-4

@article{8c9ca492accf4223ad72279981402b10,

title = "Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients",

abstract = "Clinical outcomes after a first-episode of psychosis (FEP) are heterogeneous. Many patient-related factors such as gender and comorbidity have been studied to predict symptomatic outcomes. However, psychiatrist-related factors such as prescription behaviour and gender have received little attention. We assessed the relationship between patients{\textquoteright} psychiatrists, psychosis severity and daily functioning in 201 patients remitted from an FEP for a duration of one year, treated by 18 different psychiatrists. We controlled for baseline severity, dose and type of antipsychotic medication, frequency of visits, and patients{\textquoteright} education. Symptom severity, daily functioning, and antipsychotic drug use were assessed at baseline and at 3, 6, and, 12 months follow-up. We found that psychiatrists accounted for 9.1% of the explained variance in patients{\textquoteright} symptom severity and 10.1% of the explained variance in daily functioning.These effects persisted even when controlling for factors such as baseline severity and the prescribed dose. The effect of prescribed dose on symptom severity and daily functioning differed between psychiatrists. Treatment centre, session frequency, and medication nonadherence were not related to symptom severity. Our results emphasize the importance of individual psychiatrist factors in symptomatic outcomes after an FEP. Further identification of psychiatrist-related factors such as the quality of therapeutic alliances and shared decision-making, may optimize psychiatrists{\textquoteright} training with the goal of improving patient outcomes.",

keywords = "Antipsychotic agents, Psychiatrists, Psychotic disorders, Severity of illness, Treatment outcome",

author = "{de Beer}, Franciska and Sanne Koops and Schoevers, {Robert A.} and Wim Veling and {van Beveren}, Nico and {de Haan}, Lieuwe and Nynke Boonstra and Martijn Kikkert and Begemann, {Marieke J.H.} and {van der Heijden}, Inge and Joelle Hoornaar and Ellen Graveland and Hage, {Jan Jaap} and Ruben Curfs and Cases, {Albert Batalla} and Sybren Wiersma and Selene Veerman and Natalie Veen and Staring, {Anton B.P.} and Pijnenborg, {Gerdina Hendrika Maria} and J{\"o}rg Kurkamp and Henderikus Knegtering and {de Jonge}, Martijn and Koen Grootens and Gunnar Faber and {van den Brink}, Truus and Steven Berendsen and Maarten Bak and {van Amelsvoort}, Therese and Toon Scheurink and Matej Djordjevic and Iris Hamers and Alban Voppel and Priscilla Oomen and Hag, {Erna van{\textquoteright}t} and Shiral Gangadin and Bodyl Brand and Joran Lokkerbol and Bakker, {P. Roberto} and Sinan G{\"u}l{\"o}ks{\"u}z and Rosema, {Bram Sieben} and Machteld Marcelis and Sanne Schuite-Koops and Marieke Begemann and Filip Smit and {van Os}, Jim and Iris Sommer and Sommer, {Iris E.C.} and {HAMLETT-OPHELIA Consortium}",

note = "Funding Information: The project was funded by the HAMLETT-OPHELIA project, which is financed by the Dutch Medical Science Foundation ZonMW (no. 348041003 and no. 636340001, main applicant: Dr Iris Sommer). Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

month = dec,

day = "1",

doi = "10.1038/s41598-024-72678-4",

language = "English",

volume = "14",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

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de Beer, F, Koops, S, Schoevers, RA, Veling, W, van Beveren, N, de Haan, L, Boonstra, N, Kikkert, M, Begemann, MJH, van der Heijden, I, Hoornaar, J, Graveland, E, Hage, JJ, Curfs, R, Cases, AB, Wiersma, S, Veerman, S, Veen, N, Staring, ABP, Pijnenborg, GHM, Kurkamp, J, Knegtering, H, de Jonge, M, Grootens, K, Faber, G, van den Brink, T, Berendsen, S, Bak, M , van Amelsvoort, T, Scheurink, T, Djordjevic, M, Hamers, I, Voppel, A, Oomen, P, Hag, EV, Gangadin, S, Brand, B, Lokkerbol, J, Bakker, PR, Gülöksüz, S, Rosema, BS, Marcelis, M, Schuite-Koops, S, Begemann, M, Smit, F, van Os, J, Sommer, I, Sommer, IEC & HAMLETT-OPHELIA Consortium 2024, 'Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients', Scientific Reports, vol. 14, no. 1, 22871. https://doi.org/10.1038/s41598-024-72678-4

TY - JOUR

T1 - Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients

AU - de Beer, Franciska

AU - Koops, Sanne

AU - Schoevers, Robert A.

AU - Veling, Wim

AU - van Beveren, Nico

AU - de Haan, Lieuwe

AU - Boonstra, Nynke

AU - Kikkert, Martijn

AU - Begemann, Marieke J.H.

AU - van der Heijden, Inge

AU - Hoornaar, Joelle

AU - Graveland, Ellen

AU - Hage, Jan Jaap

AU - Curfs, Ruben

AU - Cases, Albert Batalla

AU - Wiersma, Sybren

AU - Veerman, Selene

AU - Veen, Natalie

AU - Staring, Anton B.P.

AU - Pijnenborg, Gerdina Hendrika Maria

AU - Kurkamp, Jörg

AU - Knegtering, Henderikus

AU - de Jonge, Martijn

AU - Grootens, Koen

AU - Faber, Gunnar

AU - van den Brink, Truus

AU - Berendsen, Steven

AU - Bak, Maarten

AU - van Amelsvoort, Therese

AU - Scheurink, Toon

AU - Djordjevic, Matej

AU - Hamers, Iris

AU - Voppel, Alban

AU - Oomen, Priscilla

AU - Hag, Erna van’t

AU - Gangadin, Shiral

AU - Brand, Bodyl

AU - Lokkerbol, Joran

AU - Bakker, P. Roberto

AU - Gülöksüz, Sinan

AU - Rosema, Bram Sieben

AU - Marcelis, Machteld

AU - Schuite-Koops, Sanne

AU - Begemann, Marieke

AU - Smit, Filip

AU - van Os, Jim

AU - Sommer, Iris

AU - Sommer, Iris E.C.

AU - HAMLETT-OPHELIA Consortium

N1 - Funding Information: The project was funded by the HAMLETT-OPHELIA project, which is financed by the Dutch Medical Science Foundation ZonMW (no. 348041003 and no. 636340001, main applicant: Dr Iris Sommer). Publisher Copyright: © The Author(s) 2024.

PY - 2024/12/1

Y1 - 2024/12/1

N2 - Clinical outcomes after a first-episode of psychosis (FEP) are heterogeneous. Many patient-related factors such as gender and comorbidity have been studied to predict symptomatic outcomes. However, psychiatrist-related factors such as prescription behaviour and gender have received little attention. We assessed the relationship between patients’ psychiatrists, psychosis severity and daily functioning in 201 patients remitted from an FEP for a duration of one year, treated by 18 different psychiatrists. We controlled for baseline severity, dose and type of antipsychotic medication, frequency of visits, and patients’ education. Symptom severity, daily functioning, and antipsychotic drug use were assessed at baseline and at 3, 6, and, 12 months follow-up. We found that psychiatrists accounted for 9.1% of the explained variance in patients’ symptom severity and 10.1% of the explained variance in daily functioning.These effects persisted even when controlling for factors such as baseline severity and the prescribed dose. The effect of prescribed dose on symptom severity and daily functioning differed between psychiatrists. Treatment centre, session frequency, and medication nonadherence were not related to symptom severity. Our results emphasize the importance of individual psychiatrist factors in symptomatic outcomes after an FEP. Further identification of psychiatrist-related factors such as the quality of therapeutic alliances and shared decision-making, may optimize psychiatrists’ training with the goal of improving patient outcomes.

AB - Clinical outcomes after a first-episode of psychosis (FEP) are heterogeneous. Many patient-related factors such as gender and comorbidity have been studied to predict symptomatic outcomes. However, psychiatrist-related factors such as prescription behaviour and gender have received little attention. We assessed the relationship between patients’ psychiatrists, psychosis severity and daily functioning in 201 patients remitted from an FEP for a duration of one year, treated by 18 different psychiatrists. We controlled for baseline severity, dose and type of antipsychotic medication, frequency of visits, and patients’ education. Symptom severity, daily functioning, and antipsychotic drug use were assessed at baseline and at 3, 6, and, 12 months follow-up. We found that psychiatrists accounted for 9.1% of the explained variance in patients’ symptom severity and 10.1% of the explained variance in daily functioning.These effects persisted even when controlling for factors such as baseline severity and the prescribed dose. The effect of prescribed dose on symptom severity and daily functioning differed between psychiatrists. Treatment centre, session frequency, and medication nonadherence were not related to symptom severity. Our results emphasize the importance of individual psychiatrist factors in symptomatic outcomes after an FEP. Further identification of psychiatrist-related factors such as the quality of therapeutic alliances and shared decision-making, may optimize psychiatrists’ training with the goal of improving patient outcomes.

KW - Antipsychotic agents

KW - Psychiatrists

KW - Psychotic disorders

KW - Severity of illness

KW - Treatment outcome

U2 - 10.1038/s41598-024-72678-4

DO - 10.1038/s41598-024-72678-4

M3 - Article

SN - 2045-2322

VL - 14

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 22871

ER -

Psychiatrists effect on positive symptom severity and daily functioning during pharmacotherapy for first-episode psychosis patients

Abstract

Keywords

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