Services for people at high risk improve outcomes in patients with first episode psychosis

TY - JOUR

T1 - Services for people at high risk improve outcomes in patients with first episode psychosis

AU - Fusar-Poli, Paolo

AU - Díaz-Caneja, Covadonga Martínez

AU - Patel, Rashmi

AU - Valmaggia, Lucia Rita

AU - Byrne, Majella

AU - Garety, Philippa Anne

AU - Shetty, Hitesh

AU - Broadbent, Matthew

AU - Stewart, Robert James

AU - McGuire, Philip

PY - 2016/1

Y1 - 2016/1

N2 - Objective: About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services.Method: Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders.Results: FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: −33.7 to (−0.3)], had a shorter referral-to-diagnosis time [B coefficient −74.5 days, 95% CI: −101.9 to −(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39–0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34–0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services.Conclusion: Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.

AB - Objective: About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services.Method: Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders.Results: FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: −33.7 to (−0.3)], had a shorter referral-to-diagnosis time [B coefficient −74.5 days, 95% CI: −101.9 to −(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39–0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34–0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services.Conclusion: Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.

U2 - 10.1111/acps.12480

DO - 10.1111/acps.12480

M3 - Article

SN - 1600-0447

VL - 133

SP - 76

EP - 85

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 1

ER -