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

Andrew I. Gumley, Angus Macbeth, James D. Reilly, Margaret O'Grady, Ross G. White, Hamish McLeod, Matthias Schwannauer, Kevin G. Power

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)49-62
JournalBritish Journal of Clinical Psychology
Issue number1
Early online date08 Jul 2014
Publication statusPublished - Mar 2015
Externally publishedYes


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