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)

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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
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 (Online):2044-8260

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