Initial predictors of outcome in an early intervention in psychosis service

Abstract

The aims of this study were to determine medium-term outcomes of a cohort of early intervention service users after discharge from the service. Additionally, to establish whether characteristics can be easily identified in the early stages of treatment to predict outcome, aid discharge planning and focus interventions. One hundred fifty-five early intervention service users were followed-up for a mean of 4.6 years from the start of early intervention treatment. Patients were divided into good and poor outcome groups and these groups were compared on gender, duration of untreated psychosis, age at first presentation to mental health services, hospital admissions in the first year and time spent on the waiting list. A third of the patients had a good outcome, with a discharge to primary care and no subsequent return to mental health services. Good outcome was associated with a later age of first contact with mental health services and fewer hospital admissions in the first year of treatment. We would suggest that clinicians working in this and similar services could use these two factors as early as one year into treatment to begin to consider discharge planning, or conversely to focus resources most appropriately on those likely to benefit most or those who have the greatest predicted need. This study supports an optimist view of prognosis for a significant proportion of first-episode psychosis patients.