Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth
Objective: To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prio...
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| Veröffentlicht in: | Australian and New Zealand journal of psychiatry 2016-11, Vol.50 (11), p.1055-1063 |
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| container_title | Australian and New Zealand journal of psychiatry |
| container_volume | 50 |
| creator | Lappin, Julia M Heslin, Margaret Jones, Peter B Doody, Gillian A Reininghaus, Ulrich A Demjaha, Arsime Croudace, Timothy Jamieson-Craig, Thomas Donoghue, Kim Lomas, Ben Fearon, Paul Murray, Robin M Dazzan, Paola Morgan, Craig |
| description | Objective:
To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age.
Methods:
Data on first-episode psychosis patients from the ÆSOP-10 longitudinal follow-up study were used to compare baseline characteristics, and 10-year clinical, functional and service use outcomes between those patients who would and would not have met age-based criteria for early intervention services, in Australia or in the United Kingdom.
Results:
In total, 58% men and 71% women with first-episode psychosis were too old to meet current Australian-early intervention age-entry criteria (χ2 = 9.1, p = 0.003), while 21% men and 34% women were too old for UK-early intervention age-entry criteria (χ2 = 11.1, p = 0.001). The 10-year clinical and functional outcomes did not differ significantly between groups by either Australian- or UK-early intervention age-entry criteria. Service use was significantly greater among the patients young enough to meet early intervention age-criteria (Australia: incidence rate ratio = 1.35 [1.19, 1.52], p < 0.001; United Kingdom: incidence rate ratio = 1.65 [1.41, 1.93], p < 0.001).
Conclusion:
Current early intervention services are gender- and age-inequitable. Large numbers of patients with first-episode psychosis will not receive early intervention care under current service provision. Illness outcomes at 10-years were no worse in first-episode psychosis patients who presented within the age range for whom early intervention has been prioritised, though these patients had greater service use. These data provide a rationale to consider extension of early intervention to all, rather than just to youth. |
| doi_str_mv | 10.1177/0004867416673454 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5316960</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0004867416673454</sage_id><sourcerecordid>1835489366</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-55ce3214d72577f83df403d5aba92570febf445349d4c4a006fd6ac23c269673</originalsourceid><addsrcrecordid>eNp1UU1v1DAQtRCILoU7J2SJC4em2PFXckGqqhaQKvVSiaPldSYbF6-92ElLeuI_8A_5JXiVtgIkTiPPe_PeeB5Cryk5plSp94QQ3kjFqZSKccGfoBXlnFRUUv4UrfZwtccP0IucrwmhjAr1HB3USgmpFF2hr5fTaOMWMu6j9_HWhQ3uXcpjBTuXYwd4l2c7xOwy_vXjJ_4yzPgWcB7i5DvswgjpBgJgMMnP5Y2N99hsIB_hEEccw9Kd4zQOL9Gz3vgMr-7rIbo6P7s6_VRdXH78fHpyUVku67ESwgKrKe9ULZTqG9b1nLBOmLVpS4f0sO45F4y3HbfcECL7ThpbM1vLttzhEH1YZHfTegudhTAm4_Uuua1Js47G6b-R4Aa9iTdaMFoESBF4dy-Q4rcJ8qi3Llvw3gSIU9a0YYI3LZOyUMlCtSnmnKB_tKFE7yPS_0ZURt78ud7jwEMmhfB2IQQf7rQLHXwvtW2LI2F1K0jdsP0vq4WVy7X1dZxSKDf9v-1vKh-mQg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1835489366</pqid></control><display><type>article</type><title>Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><creator>Lappin, Julia M ; Heslin, Margaret ; Jones, Peter B ; Doody, Gillian A ; Reininghaus, Ulrich A ; Demjaha, Arsime ; Croudace, Timothy ; Jamieson-Craig, Thomas ; Donoghue, Kim ; Lomas, Ben ; Fearon, Paul ; Murray, Robin M ; Dazzan, Paola ; Morgan, Craig</creator><creatorcontrib>Lappin, Julia M ; Heslin, Margaret ; Jones, Peter B ; Doody, Gillian A ; Reininghaus, Ulrich A ; Demjaha, Arsime ; Croudace, Timothy ; Jamieson-Craig, Thomas ; Donoghue, Kim ; Lomas, Ben ; Fearon, Paul ; Murray, Robin M ; Dazzan, Paola ; Morgan, Craig</creatorcontrib><description>Objective:
To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age.
Methods:
Data on first-episode psychosis patients from the ÆSOP-10 longitudinal follow-up study were used to compare baseline characteristics, and 10-year clinical, functional and service use outcomes between those patients who would and would not have met age-based criteria for early intervention services, in Australia or in the United Kingdom.
Results:
In total, 58% men and 71% women with first-episode psychosis were too old to meet current Australian-early intervention age-entry criteria (χ2 = 9.1, p = 0.003), while 21% men and 34% women were too old for UK-early intervention age-entry criteria (χ2 = 11.1, p = 0.001). The 10-year clinical and functional outcomes did not differ significantly between groups by either Australian- or UK-early intervention age-entry criteria. Service use was significantly greater among the patients young enough to meet early intervention age-criteria (Australia: incidence rate ratio = 1.35 [1.19, 1.52], p < 0.001; United Kingdom: incidence rate ratio = 1.65 [1.41, 1.93], p < 0.001).
Conclusion:
Current early intervention services are gender- and age-inequitable. Large numbers of patients with first-episode psychosis will not receive early intervention care under current service provision. Illness outcomes at 10-years were no worse in first-episode psychosis patients who presented within the age range for whom early intervention has been prioritised, though these patients had greater service use. These data provide a rationale to consider extension of early intervention to all, rather than just to youth.</description><identifier>ISSN: 0004-8674</identifier><identifier>EISSN: 1440-1614</identifier><identifier>DOI: 10.1177/0004867416673454</identifier><identifier>PMID: 27756771</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Age of Onset ; Early Medical Intervention - statistics & numerical data ; Evaluation ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Health Services - statistics & numerical data ; Mentally ill ; Mentally ill teenagers ; Outcome Assessment, Health Care - statistics & numerical data ; Patient Acceptance of Health Care - statistics & numerical data ; Psychiatry ; Psychoses ; Psychotic Disorders - therapy ; Services for ; United Kingdom ; Young Adult</subject><ispartof>Australian and New Zealand journal of psychiatry, 2016-11, Vol.50 (11), p.1055-1063</ispartof><rights>The Royal Australian and New Zealand College of Psychiatrists 2016</rights><rights>The Royal Australian and New Zealand College of Psychiatrists 2016.</rights><rights>The Royal Australian and New Zealand College of Psychiatrists 2016 2016 The Royal Australian and New Zealand College of Psychiatrists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-55ce3214d72577f83df403d5aba92570febf445349d4c4a006fd6ac23c269673</citedby><cites>FETCH-LOGICAL-c462t-55ce3214d72577f83df403d5aba92570febf445349d4c4a006fd6ac23c269673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0004867416673454$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0004867416673454$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,21799,27903,27904,43600,43601</link.rule.ids><backlink>$$Uhttps://natlib-primo.hosted.exlibrisgroup.com/primo-explore/search?query=any,contains,998930329502837&tab=innz&search_scope=INNZ&vid=NLNZ&offset=0$$DView this record in NLNZ$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27756771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lappin, Julia M</creatorcontrib><creatorcontrib>Heslin, Margaret</creatorcontrib><creatorcontrib>Jones, Peter B</creatorcontrib><creatorcontrib>Doody, Gillian A</creatorcontrib><creatorcontrib>Reininghaus, Ulrich A</creatorcontrib><creatorcontrib>Demjaha, Arsime</creatorcontrib><creatorcontrib>Croudace, Timothy</creatorcontrib><creatorcontrib>Jamieson-Craig, Thomas</creatorcontrib><creatorcontrib>Donoghue, Kim</creatorcontrib><creatorcontrib>Lomas, Ben</creatorcontrib><creatorcontrib>Fearon, Paul</creatorcontrib><creatorcontrib>Murray, Robin M</creatorcontrib><creatorcontrib>Dazzan, Paola</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><title>Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth</title><title>Australian and New Zealand journal of psychiatry</title><addtitle>Aust N Z J Psychiatry</addtitle><description>Objective:
To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age.
Methods:
Data on first-episode psychosis patients from the ÆSOP-10 longitudinal follow-up study were used to compare baseline characteristics, and 10-year clinical, functional and service use outcomes between those patients who would and would not have met age-based criteria for early intervention services, in Australia or in the United Kingdom.
Results:
In total, 58% men and 71% women with first-episode psychosis were too old to meet current Australian-early intervention age-entry criteria (χ2 = 9.1, p = 0.003), while 21% men and 34% women were too old for UK-early intervention age-entry criteria (χ2 = 11.1, p = 0.001). The 10-year clinical and functional outcomes did not differ significantly between groups by either Australian- or UK-early intervention age-entry criteria. Service use was significantly greater among the patients young enough to meet early intervention age-criteria (Australia: incidence rate ratio = 1.35 [1.19, 1.52], p < 0.001; United Kingdom: incidence rate ratio = 1.65 [1.41, 1.93], p < 0.001).
Conclusion:
Current early intervention services are gender- and age-inequitable. Large numbers of patients with first-episode psychosis will not receive early intervention care under current service provision. Illness outcomes at 10-years were no worse in first-episode psychosis patients who presented within the age range for whom early intervention has been prioritised, though these patients had greater service use. These data provide a rationale to consider extension of early intervention to all, rather than just to youth.</description><subject>Adult</subject><subject>Age of Onset</subject><subject>Early Medical Intervention - statistics & numerical data</subject><subject>Evaluation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Health Services - statistics & numerical data</subject><subject>Mentally ill</subject><subject>Mentally ill teenagers</subject><subject>Outcome Assessment, Health Care - statistics & numerical data</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Psychiatry</subject><subject>Psychoses</subject><subject>Psychotic Disorders - therapy</subject><subject>Services for</subject><subject>United Kingdom</subject><subject>Young Adult</subject><issn>0004-8674</issn><issn>1440-1614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp1UU1v1DAQtRCILoU7J2SJC4em2PFXckGqqhaQKvVSiaPldSYbF6-92ElLeuI_8A_5JXiVtgIkTiPPe_PeeB5Cryk5plSp94QQ3kjFqZSKccGfoBXlnFRUUv4UrfZwtccP0IucrwmhjAr1HB3USgmpFF2hr5fTaOMWMu6j9_HWhQ3uXcpjBTuXYwd4l2c7xOwy_vXjJ_4yzPgWcB7i5DvswgjpBgJgMMnP5Y2N99hsIB_hEEccw9Kd4zQOL9Gz3vgMr-7rIbo6P7s6_VRdXH78fHpyUVku67ESwgKrKe9ULZTqG9b1nLBOmLVpS4f0sO45F4y3HbfcECL7ThpbM1vLttzhEH1YZHfTegudhTAm4_Uuua1Js47G6b-R4Aa9iTdaMFoESBF4dy-Q4rcJ8qi3Llvw3gSIU9a0YYI3LZOyUMlCtSnmnKB_tKFE7yPS_0ZURt78ud7jwEMmhfB2IQQf7rQLHXwvtW2LI2F1K0jdsP0vq4WVy7X1dZxSKDf9v-1vKh-mQg</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Lappin, Julia M</creator><creator>Heslin, Margaret</creator><creator>Jones, Peter B</creator><creator>Doody, Gillian A</creator><creator>Reininghaus, Ulrich A</creator><creator>Demjaha, Arsime</creator><creator>Croudace, Timothy</creator><creator>Jamieson-Craig, Thomas</creator><creator>Donoghue, Kim</creator><creator>Lomas, Ben</creator><creator>Fearon, Paul</creator><creator>Murray, Robin M</creator><creator>Dazzan, Paola</creator><creator>Morgan, Craig</creator><general>SAGE Publications</general><scope>AFRWT</scope><scope>DUNLO</scope><scope>GOM</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201611</creationdate><title>Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth</title><author>Lappin, Julia M ; Heslin, Margaret ; Jones, Peter B ; Doody, Gillian A ; Reininghaus, Ulrich A ; Demjaha, Arsime ; Croudace, Timothy ; Jamieson-Craig, Thomas ; Donoghue, Kim ; Lomas, Ben ; Fearon, Paul ; Murray, Robin M ; Dazzan, Paola ; Morgan, Craig</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-55ce3214d72577f83df403d5aba92570febf445349d4c4a006fd6ac23c269673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age of Onset</topic><topic>Early Medical Intervention - statistics & numerical data</topic><topic>Evaluation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Health Services - statistics & numerical data</topic><topic>Mentally ill</topic><topic>Mentally ill teenagers</topic><topic>Outcome Assessment, Health Care - statistics & numerical data</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Psychiatry</topic><topic>Psychoses</topic><topic>Psychotic Disorders - therapy</topic><topic>Services for</topic><topic>United Kingdom</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lappin, Julia M</creatorcontrib><creatorcontrib>Heslin, Margaret</creatorcontrib><creatorcontrib>Jones, Peter B</creatorcontrib><creatorcontrib>Doody, Gillian A</creatorcontrib><creatorcontrib>Reininghaus, Ulrich A</creatorcontrib><creatorcontrib>Demjaha, Arsime</creatorcontrib><creatorcontrib>Croudace, Timothy</creatorcontrib><creatorcontrib>Jamieson-Craig, Thomas</creatorcontrib><creatorcontrib>Donoghue, Kim</creatorcontrib><creatorcontrib>Lomas, Ben</creatorcontrib><creatorcontrib>Fearon, Paul</creatorcontrib><creatorcontrib>Murray, Robin M</creatorcontrib><creatorcontrib>Dazzan, Paola</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Index New Zealand (A&I)</collection><collection>Index New Zealand</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Australian and New Zealand journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lappin, Julia M</au><au>Heslin, Margaret</au><au>Jones, Peter B</au><au>Doody, Gillian A</au><au>Reininghaus, Ulrich A</au><au>Demjaha, Arsime</au><au>Croudace, Timothy</au><au>Jamieson-Craig, Thomas</au><au>Donoghue, Kim</au><au>Lomas, Ben</au><au>Fearon, Paul</au><au>Murray, Robin M</au><au>Dazzan, Paola</au><au>Morgan, Craig</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth</atitle><jtitle>Australian and New Zealand journal of psychiatry</jtitle><addtitle>Aust N Z J Psychiatry</addtitle><date>2016-11</date><risdate>2016</risdate><volume>50</volume><issue>11</issue><spage>1055</spage><epage>1063</epage><pages>1055-1063</pages><issn>0004-8674</issn><eissn>1440-1614</eissn><abstract>Objective:
To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age.
Methods:
Data on first-episode psychosis patients from the ÆSOP-10 longitudinal follow-up study were used to compare baseline characteristics, and 10-year clinical, functional and service use outcomes between those patients who would and would not have met age-based criteria for early intervention services, in Australia or in the United Kingdom.
Results:
In total, 58% men and 71% women with first-episode psychosis were too old to meet current Australian-early intervention age-entry criteria (χ2 = 9.1, p = 0.003), while 21% men and 34% women were too old for UK-early intervention age-entry criteria (χ2 = 11.1, p = 0.001). The 10-year clinical and functional outcomes did not differ significantly between groups by either Australian- or UK-early intervention age-entry criteria. Service use was significantly greater among the patients young enough to meet early intervention age-criteria (Australia: incidence rate ratio = 1.35 [1.19, 1.52], p < 0.001; United Kingdom: incidence rate ratio = 1.65 [1.41, 1.93], p < 0.001).
Conclusion:
Current early intervention services are gender- and age-inequitable. Large numbers of patients with first-episode psychosis will not receive early intervention care under current service provision. Illness outcomes at 10-years were no worse in first-episode psychosis patients who presented within the age range for whom early intervention has been prioritised, though these patients had greater service use. These data provide a rationale to consider extension of early intervention to all, rather than just to youth.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>27756771</pmid><doi>10.1177/0004867416673454</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0004-8674 |
| ispartof | Australian and New Zealand journal of psychiatry, 2016-11, Vol.50 (11), p.1055-1063 |
| issn | 0004-8674 1440-1614 |
| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Adult Age of Onset Early Medical Intervention - statistics & numerical data Evaluation Female Follow-Up Studies Humans Male Mental Health Services - statistics & numerical data Mentally ill Mentally ill teenagers Outcome Assessment, Health Care - statistics & numerical data Patient Acceptance of Health Care - statistics & numerical data Psychiatry Psychoses Psychotic Disorders - therapy Services for United Kingdom Young Adult |
| title | Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth |
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