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Ethnic variations have previously been identified in the duration of untreated psychosis (DUP) and pathways into psychiatric services. These have not been examined in the context of early intervention services, which may alter these trajectories.
To explore ethnic differences in the nature and duration of pathways into early intervention services.
In a naturalistic cohort study, data were collected for 1024 individuals with psychotic disorders accepted for case management by eight London early intervention services.
Duration of untreated psychosis was prolonged in the White British group compared with most other ethnic groups. White British individuals were more likely to make contact with their general practitioner and less likely to be seen within emergency medical services. All Black patient groups were more likely than their White British counterparts to experience involvement of criminal justice agencies.
Variations continue to exist in how and when individuals from different ethnic groups access early intervention services. These may account for disparities in DUP.
The provision of early intervention services for people with psychosis is
UK government policy, although evidence for benefit of such services is
To evaluate the effects of a service providing specialised care for early
psychosis (the Lambeth Early Onset team) on clinical and social outcomes,
and on service user satisfaction.
One hundred and forty-four people with psychosis, presenting to mental
health services for the first or second time (if previously failed to
engage in treatment), were randomly allocated to care by the early onset
team or to standard care. Information was obtained on symptoms, treatment
adherence, social and vocational functioning, satisfaction and quality of
life. Relapse and rehospitalisation data have been reported
Outcomes for the participants treated by the early onset team were
significantly better at 18 months for aspects of social and vocational
functioning, satisfaction, quality of life and medication adherence.
Symptom improvement did not significantly differ between the groups.
The provision of specialised care for early psychosis can achieve better
outcomes. The study therefore provides support for current policy.
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