Outcomes for 236 patients from a 2-year early intervention in psychosis service

• Published in: Acta Psychiatrica Scandinavica Vol. 120; no. 2; pp. 129 - 137
• Main Authors: Turner, M. A., Boden, J. M., Smith-Hamel, C., Mulder, R. T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2009; Blackwell
• Subjects: Adolescent; Adult; Antipsychotic Agents - therapeutic use; Biological and medical sciences; Clinical outcomes; Cognitive Therapy - methods; Combined Modality Therapy; Diagnostic and Statistical Manual of Mental Disorders; early intervention; Female; first episode; Health Education; Humans; Intelligence; Intelligence Tests; Male; Medical sciences; Mental disorders; Mental health care; Mental Health Services - utilization; outcomes; Patient Care Team; Patient Education as Topic; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; psychoses; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - drug therapy; Psychotic Disorders - therapy; Referral and Consultation; Retention (Psychology); Social Facilitation; Social psychology; Time Factors; Treatment Outcome; Young Adult; Human; Psychosis; First episode; early intervention; outcomes; Early; psychoses
• ISSN: 0001-690X; 1600-0447; 0065-1591
• DOI: 10.1111/j.1600-0447.2009.01386.x

Objective:  To examine: i) changes in key outcome measures over time in treatment in a representative first‐episode psychosis treatment cohort and ii) baseline predictors of service disengagement.
Method:  Baseline characteristics of 236 patients were examined for associations with outcomes over time using generalized estimating equation models. The data on disengagement were analysed using logistic regression.
Results:  After controlling for admission scores, patients showed consistently improved outcomes while in treatment on functional recovery (unemployment, P < 0.01; HoNOS, P < 0.001; the Quality of Life Scale, P < 0.001; GAF, P < 0.05) but not symptomatology (as assessed by the PANSS and substance abuse). The 64 (33%) who disengaged were more likely to be unemployed (P < 0.01) and have higher HoNOS (P < 0.01) and GAF (P < 0.05) scores at baseline.
Conclusion:  This evaluation has shown significant improvements in psychosocial functioning but not psychopathology during treatment at an Early Intervention for Psychosis Service. Despite attempts to retain patients, there is a high rate of treatment discontinuation.