Almost two-thirds of people who suffered psychosis were in remission 20 years later

Study finds long-term outcomes for psychosis may be better than previously thought

Almost two-thirds of people who suffered a psychotic episode were in remission 20 years later, according to a follow-up study by Irish scientists.

Just over half of those who had presented to mental health services with a first episode of psychosis said they were “fully recovered according to their own personal definition of recovery”, the study found.

But only 35.2 per cent met the combined criteria of remission and functional or vocational recovery, the iHope-20 (Irish Health Outcomes in Psychosis Evaluation) team found.

The research followed up 171 Irish people 20 years after they had presented to the Cluain Mhuire mental health service and St John of God Hospital in Dublin in the 1990s.


Of the one-third of people who were still experiencing episodes of psychosis, outcomes were better for people who were treated early, had good social functioning in their youth and – when first assessed – were older, not living alone, and in full-time employment.

Of this group, many were unemployed, not in education, or were acting as a homemaker; and some were having difficulty engaging in basic living tasks.

The study found the mortality rate of the group was higher than that of the general population; 20 people (11.7 per cent) had died within 20 years of experiencing psychosis for the first time.

It is estimated that up to three out of every 100 Irish people will experience an episode of psychosis in their lifetime.

The study reiterated the importance of seeking help from mental health services as soon as possible, after people first experience psychosis.

Lead author and psychologist Donal O’Keeffe said there were many positive findings in the study.

“It shows that there is a good chance many people will do well if they receive treatment early. The long-term outcomes for psychosis may be better than previously thought. However, there needs to be more investment in treatments that help people in their functional and vocational recovery.”

While the causes of psychosis are unclear, risk factors include a genetic predisposition, exposure to trauma in childhood, and cannabis use – in particular strains of ‘skunk’ that contain high levels of THC (Tetrahydrocannabinol, the psychoactive component of cannabis).

The study, which has been published in Australian and New Zealand Journal of Psychiatry, was funded by the Health Research Board and supported by Saint John of God Research Foundation.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.