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Retrospective study of a first-episode psychosis service embedded within a home-based treatment team

Published online by Cambridge University Press:  27 May 2019

Nuala Murray  and
Karen O’Connor
Nuala Murray
Affiliation:
University College Cork, College Rd., Cork, Ireland
Karen O’Connor*
Affiliation:
Consultant Psychiatrist, Home Based Treatment Team & Early Intervention for Psychosis Service, South Lee Mental Health Services, Cork, Ireland
*
*Address for correspondence: Karen O’Connor, Consultant Psychiatrist, Home Based Treatment Team & Early Intervention for Psychosis Service, South Lee Mental Health Services, Cork, Ireland (Email: Karen.oconnor3@hse.ie)
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Abstract

Objectives

To evaluate if having an early intervention service (EIS), which is embedded within a home-based treatment team (HBTT), is associated with (1) shorter duration of untreated psychosis (DUP), (2) lower rates of hospital admissions at first presentation, (3) a lesser number of hospital admissions within 6 months of presentation and (4) a reduced mean bed usage for the first 6 months.

Methods

The files of those who presented with a first-episode psychosis (FEP) to the South Lee Mental Health Service from January 2016 to February 2017 were identified and a retrospective case review was carried out. The demographics, clinical characteristics and hospital admissions were compared for those admitted to either the EIS or community mental health teams.

Results

Forty patients were assessed. DUP was found to be longer for those who presented to the EIS (U = 121, p = 0.03). There were fewer admissions at first presentation (χ2 (1) = 6.51 p = 0.01), fewer admissions within the first 6 months of presentation (χ2 (1) = 5.56 p = 0.02) and less bed usage overall (U = 131, p = 0.047) for those who presented to the EIS.

Conclusion

The study provides a baseline clinical and demographic profile of patients with FEP in an Irish mental health service and demonstrates current pathways to care. EIS embedded within an HBTT was associated with fewer hospital admissions and less bed usage. It is unclear whether these findings may have occurred due to the EIS or due to the benefits provided by an HBTT.

Keywords

Early interventionfirst-episode psychosispatient outcome assessmentservice development
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 36 , Issue 4: Psychosis: from early intervention to treatment resistance , December 2019 , pp. 265 - 269
Copyright
© College of Psychiatrists of Ireland 2019 

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References

Behan, C, Kennelly, B, O’Callaghan, E (2008). The economic cost of schizophrenia in Ireland: a cost of illness study. Irish Journal of Psychological Medicine 25, 80–87.CrossRefGoogle ScholarPubMed
Clarke, A-M, McLaughlin, P, Staunton, J, Kerins, K, Power, B, Kearney, K, McGuinness, M, Whitty, P (2017). Retrospective study of first episode psychosis in the Dublin Southwest Mental Health Service: demographics, clinical profile and service evaluation of treatment. Irish Journal of Psychological Medicine 34, 1–10.CrossRefGoogle Scholar
Craig, TK, Garety, P, Power, P, Rahaman, N, Colbert, S, Fornells-Ambrojo, M, Dunn, G (2004). The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 329, 1067.CrossRefGoogle ScholarPubMed
Health Service Executive (2011a). National Mental Health Programme Plan. (https://health.gov.ie/wpcontent/uploads/2014/04/National_Mental_Health_Programme_Plan_Nov2011). Accessed 05 November 2018.Google Scholar
Health Service Executive (2011b). Five year report on the Detect early intervention for psychosis service. (http://www.detect.ie/documents/5YEARDETECTREPORT2011_000.pdf). Accessed 05 November 2018)Google Scholar
Kingston, T, Owoeye, O, Kinsella, A, Russell, V, O’Callaghan, E, Waddington, JL (2011). Schizophrenia spectrum disorders in relation to the totality of psychosis: from first episode to long-term outcome. In Handbook of Schizophrenia Spectrum Disorders, Vol. II, pp. 269–279. Dordrecht Heidelberg London New York: Springer.CrossRefGoogle Scholar
Kirkbride, JB, Errazuriz, A, Croudace, TJ, Morgan, C, Jackson, D, Boydell, J, Murray, RM, Jones, PB (2012). Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PloS One 7, e31660.CrossRefGoogle ScholarPubMed
Kirkbride, JB, Jackson, D, Perez, J, Fowler, D, Winton, F, Coid, JW, Murray, RM, Jones, PB (2013). A population-level prediction tool for the incidence of first-episode psychosis: translational epidemiology based on cross-sectional data. BMJ Open 3, e001998.CrossRefGoogle ScholarPubMed
Lester, H, Birchwood, M, Bryan, S, England, E, Rogers, H, Sirvastava, N (2009). Development and implementation of early intervention services for young people with psychosis: case study. The British Journal of Psychiatry 194, 446–450.CrossRefGoogle ScholarPubMed
Malla, AK, Norman, RM, Manchanda, R, Ahmed, MR, Scholten, D, Harricharan, R, Cortese, L, Takhar, J (2002). One year outcome in first episode psychosis: influence of DUP and other predictors. Schizophrenia Research 54, 231–242.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (2014). Psychosis and schizophrenia in adults: treatment and management. (https://www.nice.org.uk/guidance/cg178/evidence/full-guideline-490503565). Accessed 06 November 2018.Google Scholar
Perkins, DO, Gu, H, Boteva, K, Lieberman, JA (2005). Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. American Journal of Psychiatry 162, 1785–1804.CrossRefGoogle ScholarPubMed
Robinson, DG, Woerner, MG, Alvir, JMJ, Geisler, S, Koreen, A, Sheitman, B, Chakos, M, Mayerhoff, D, Bilder, R, Goldman, R (1999). Predictors of treatment response from a first episode of schizophrenia or schizoaffective disorder. American Journal of Psychiatry 156, 544–549.Google ScholarPubMed
Singh, SP, Croudace, T, Amin, S, Kwiecinski, R, Medley, I, Jones, PB, Harrison, G (2000). Three-year outcome of first-episode psychoses in an established community psychiatric service. The British Journal of Psychiatry 176, 210–216.CrossRefGoogle Scholar
World Health Organization (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization. (https://books.google.ie/books?hl=en&lr=&id=DFM0DgAAQBAJ&oi=fnd&pg=PR1&dq=Icd+10&ots=g30PxBQP_u&sig=QWV_zqr5RSPUK-nK4xKJBeG-nJ0&redir_esc=y#v=onepage&q=Icd%2010&f=false). Accessed 01 November 2018.Google Scholar