Abstract
Background: Around one third of people referred to prodromal clinics for the diagnosis and treatment of ultra-high-risk symptoms present with overt first episode psychosis (FEP). We investigated clinical outcomes among this group compared to those presenting to standard mental health services in South London.
Method: 164 people with FEP presenting to the OASIS prodromal clinic were compared with 2,779 presenting to standard mental health services. Outcome data on number of hospital admissions, number of inpatient days and compulsory hospital admission were obtained from electronic clinical records. Age, gender, ethnicity, marital status, employment status, diagnosis, borough of residence and antipsychotic therapy were entered as covariates in multivariable analyses.
Results: People with FEP presenting to OASIS were more likely to be male (68.3%), younger (mean age 23.6 years) and from a Black and Minority Ethnic (BME) group (68.9%) compared with FEP people in standard mental health services (59.8% male; mean age 25.1 years; 55.5% BME). Presentation to the prodromal clinic was associated with reduced frequency of hospital admission (IRR 0.49, 95% CI 0.39–0.61), fewer days spent in hospital (B coefficient −17.0 days, 95% CI −33.7, −0.3) and reduced likelihood of compulsory hospital admission (OR 0.52, 95% CI 0.34–0.81) at 2 year follow-up.
Conclusions: Presentation with FEP to a prodromal clinic was associated with better clinical outcomes compared to standard mental health services. These findings suggest a potential role for prodromal clinics to facilitate access to healthcare for people with FEP who may otherwise face difficulties in engaging with traditional mental health services.
Method: 164 people with FEP presenting to the OASIS prodromal clinic were compared with 2,779 presenting to standard mental health services. Outcome data on number of hospital admissions, number of inpatient days and compulsory hospital admission were obtained from electronic clinical records. Age, gender, ethnicity, marital status, employment status, diagnosis, borough of residence and antipsychotic therapy were entered as covariates in multivariable analyses.
Results: People with FEP presenting to OASIS were more likely to be male (68.3%), younger (mean age 23.6 years) and from a Black and Minority Ethnic (BME) group (68.9%) compared with FEP people in standard mental health services (59.8% male; mean age 25.1 years; 55.5% BME). Presentation to the prodromal clinic was associated with reduced frequency of hospital admission (IRR 0.49, 95% CI 0.39–0.61), fewer days spent in hospital (B coefficient −17.0 days, 95% CI −33.7, −0.3) and reduced likelihood of compulsory hospital admission (OR 0.52, 95% CI 0.34–0.81) at 2 year follow-up.
Conclusions: Presentation with FEP to a prodromal clinic was associated with better clinical outcomes compared to standard mental health services. These findings suggest a potential role for prodromal clinics to facilitate access to healthcare for people with FEP who may otherwise face difficulties in engaging with traditional mental health services.
| Original language | English |
|---|---|
| Article number | A98 |
| Pages (from-to) | 88-88 |
| Number of pages | 1 |
| Journal | Early Intervention in Psychiatry |
| Volume | 8 |
| Issue number | S1 |
| DOIs | |
| Publication status | Published - 11 Nov 2014 |