Fear of recurrence: results of a randomized trial of relapse detection in schizophrenia

Gumley, A. I. , MacBeth, A., Reilly, J., O'Grady, M., White, R. G. , McLeod, H. , Schwannauer, M. and Power, K. G. (2015) Fear of recurrence: results of a randomized trial of relapse detection in schizophrenia. British Journal of Clinical Psychology, 54(1), pp. 49-62. (doi: 10.1111/bjc.12060)

Abstract

Objective: We aimed to develop and establish the reliability and validity of a measure of Fear of Recurrence, measuring cognitive appraisals of relapse rather than standard early signs of relapse. We also aimed to establish the sensitivity and specificity to relapse. Method: Participants diagnosed with schizophrenia or a related disorder were randomized to one of two early signs monitoring conditions, using either the Early Signs Scale or the Fear of Recurrence Scale (FoRSe). Participants were followed up for 6-months or until relapse. Results: A total of 169 participants were randomized to Standard (n = 86) or FoRSe (n = 83) monitoring. We found good evidence supporting reliability and validity of the FoRSe. In addition, a cut-off point of ≥5 was associated with an optimal sensitivity in both Standard (n = 26:79%, 95% CI = 62–89) and FoRSe (n = 18:72%, 95% CI = 52–86) monitoring. However, this degree of sensitivity was associated with a lower specificity in Standard (n = 30:35%, 96% CI = 23–50) and FoRSe (n = 25:46%, 95% CI = 32–60). Finally, Fear of Relapse was a significant predictor of time to relapse [Exp(β) = 1.20, 95% CI = 1.01–1.42, p < .05]. Conclusion: The study provides evidence that Fear of Recurrence may be an important clinical construct linked to increased risk of relapse and poorer emotional recovery in people diagnosed with schizophrenia.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: White, Dr Ross and MacBeth, Mr Angus and McLeod, Professor Hamish and Gumley, Professor Andrew
• Authors: Gumley, A. I., MacBeth, A., Reilly, J., O'Grady, M., White, R. G., McLeod, H., Schwannauer, M., and Power, K. G.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: British Journal of Clinical Psychology
• Publisher: John Wiley & Sons Ltd.
• ISSN: 0144-6657
• ISSN (Online): 2044-8260