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Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase

  • Lucia R. Valmaggia (a1), Majella Byrne (a1), Fern Day (a2), Matthew R. Broome (a3), Louise Johns (a4), Oliver Howes (a2), Paddy Power (a4), Steven Badger (a5), Paolo Fusar-Poli (a1) and Philip K. McGuire (a1)...

Abstract

Background

It is unknown whether prodromal services improve outcomes in those who go on to develop psychosis, and whether these patients are demographically different from the overall first-episode population.

Aims

To compare sociodemographic features, duration of untreated psychosis, hospital admission and frequency of compulsory treatment in the first year after the onset of psychosis in patients who present to prodromal services with patients who did not present to services until the first episode of psychosis.

Method

We compared two groups of patients with first-episode psychosis: one who made transition after presenting in the prodromal phase and the other who had presented with a first episode.

Results

The patients who had presented before the first episode were more likely to be employed and less likely to belong to an ethnic minority group. They had a shorter duration of untreated psychosis, and were less likely to have been admitted to hospital and to have required compulsory treatment.

Conclusions

Patients who develop psychosis after being engaged in the prodromal phase have a better short-term clinical outcome than patients who do not present until the first episode. Patients who present during first episodes may be more likely to have sociodemographic features associated with relatively poor outcomes.

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Copyright

Corresponding author

Lucia Valmaggia, King's College London, Institute of Psychiatry (PO 77), De Crespigny Park, London SE5 8AF, UK. Email: lucia.valmaggia@kcl.ac.uk

Footnotes

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Declaration of interest

None.

Footnotes

References

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1 NICE. Psychosis and Schizophrenia in Children and Young People. Recognition and Management. The British Psychological Society and The Royal College of Psychiatrists, 2013.
2 Fusar-Poli, P, Bonoldi, I, Yung, AR, Borgwardt, S, Kempton, MJ, Valmaggia, L, et al. Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 2012; 69: 220–9.
3 Fusar-Poli, P, Bechdolf, A, Taylor, MJ, Bonoldi, I, Carpenter, WT, Yung, AR, et al. At risk for schizophrenic or affective psychoses? A meta-analysis of DSM/ICD diagnostic outcomes in individuals at high clinical risk. Schizophr Bull 2013; 39: 923–32.
4 Valmaggia, LR, McCrone, P, Knapp, M, Woolley, JB, Broome, MR, Tabraham, P, et al. Economic impact of early intervention in people at high risk of psychosis. Psychol Med 2009; 39: 1617–26.
5 Hegelstad, WT, Larsen, TK, Auestad, B, Evensen, J, Haahr, U, Joa, I, et al. Longterm follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome. Am J Psychiatry 2012; 169: 374–80.
6 Fusar-Poli, P, Byrne, M, Badger, S, Valmaggia, LR, McGuire, PK. Outreach and support in south London (OASIS), 2001–2011: ten years of early diagnosis and treatment for young individuals at high clinical risk for psychosis. Eur Psychiatry J Assoc Eur Psychiatrists 2013; 28: 315–26.
7 Power, P, McGuire, P, Iacoponi, E, Garety, P, Morris, E, Valmaggia, L, et al. Lambeth early onset (LEO) and outreach & support in south London (OASIS) service. Early Interv Psychia 2007; 1: 97103.
8 Yung, AR, Phillips, LJ, McGorry, PD, McFarlane, CA, Francey, S, Harrigan, S, et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry Suppl 1998; 172: 1420.
9 Reynolds, N, Wuyts, P, Badger, S, Fusar-Poli, P, McGuire, P, Valmaggia, L. The impact of delivering GP training on the clinical high risk and first-episode psychosis on referrals and pathways to care. Early Interv Psychiatry 2014; doi: 10.1111/eip.12126.
10 Phillips, LJ, Yung, AR, McGorry, PD. Identification of young people at risk of psychosis: validation of personal assessment and crisis evaluation clinic intake criteria. Aust N Z J Psychiatry 2000; 34: S1649.
11 Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M, et al. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry 2005; 39: 964–71.
12 Craig, TK, Garety, P, Power, P, Rahaman, N, Colbert, S, Fornells-Ambrojo, M, et al. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 2004; 329: 1067.
13 Morgan, C, Fearon, P, Hutchinson, G, McKenzie, K, Lappin, JM, Abdul-Al, R, et al. Duration of untreated psychosis and ethnicity in the AESOP first-onset psychosis study. Psychol Med 2006; 36: 239–47.
14 Drake, RJ, Haley, CJ, Akhtar, S, Lewis, SW. Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry 2000; 177: 511–5.
15 Norman, RM, Townsend, L, Malla, AK. Duration of untreated psychosis and cognitive functioning in first-episode patients. Br J Psychiatry 2001; 179: 340–5.
16 Green, CE, McGuire, PK, Ashworth, M, Valmaggia, LR. Outreach and support in south London (OASIS). Outcomes of non-attenders to a service for people at high risk of psychosis: the case for a more assertive approach to assessment. Psychol Med 2011; 41: 243–50.
17 Lappin, JM, Morgan, KD, Valmaggia, LR, Broome, MR, Woolley, JB, Johns, LC, et al. Insight in individuals with an at risk mental state. Schizophr Res 2007; 90: 238–44.
18 Marshall, M, Lewis, S, Lockwood, A, Drake, R, Jones, P, Croudace, T. Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry 2005; 62: 975–83.
19 Melle, I, Larsen, TK, Haahr, U, Friis, S, Johannesen, JO, Opjordsmoen, S, et al. Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. Arch Gen Psychiatry 2008; 65: 634–40.
20 Queirazza, F, Semple, DM, Lawrie, SM. Transition to schizophrenia in acute and transient psychotic disorders. Br J Psychiatry 2014; 204: 299305.
21 Fearon, P, Kirkbride, JB, Morgan, C, Dazzan, P, Morgan, K, Lloyd, T, et al. Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP study. Psychol Med 2006; 36: 1541–50.
22 Chorlton, E, McKenzie, K, Morgan, C, Doody, G. Course and outcome of psychosis in black Caribbean populations and other ethnic groups living in the UK: a systematic review. Int J Social Psychiatry 2012; 58: 400–8.
23 Morgan, C, Lappin, J, Heslin, M, Croudace, T, Doody, G, Donoghue, K, et al. Ethnicity, social disadvantage and the long-term course and outcome of psychosis. Schzophr Res 2014; 153: S348.
24 Anderson, KK, Flora, N, Archie, S, Morgan, C, McKenzie, K. A meta-analysis of ethnic differences in pathways to care at the first episode of psychosis. Acta Psychiatrica Scand 2014; 130: 257–68.
25 Jarrett, M, Craig, T, Parrott, J, Forrester, A, Winton-Brown, T, Maguire, H, et al. Identifying men at ultra high risk of psychosis in a prison population. Schizophr Res 2012; 136: 16.
26 Morgan, C, Lappin, J, Heslin, M, Donoghue, K, Lomas, B, Reininghaus, U, et al. Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study. Psychol Med 2014; 44: 114.
27 Valmaggia, LR, Day, FL, Jones, C, Bissoli, S, Pugh, C, Hall, D, et al. Cannabis use and transition to psychosis in people at ultra-high risk. Psychol Med 2014; 44: 2503–12.
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  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase

  • Lucia R. Valmaggia (a1), Majella Byrne (a1), Fern Day (a2), Matthew R. Broome (a3), Louise Johns (a4), Oliver Howes (a2), Paddy Power (a4), Steven Badger (a5), Paolo Fusar-Poli (a1) and Philip K. McGuire (a1)...
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