Services for people at high risk improve outcomes in patients with first episode psychosis

Acta Psychiatr Scand. 2016 Jan;133(1):76-85. doi: 10.1111/acps.12480. Epub 2015 Sep 11.


Objective: About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services.

Method: Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders.

Results: FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: -33.7 to (-0.3)], had a shorter referral-to-diagnosis time [B coefficient -74.5 days, 95% CI: -101.9 to -(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39-0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34-0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services.

Conclusion: Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.

Keywords: ARMS; CRIS; SLaM; UHR; first episode psychosis; prodromal; psychosis risk; schizophrenia.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Early Diagnosis
  • Episode of Care*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services
  • Patient Outcome Assessment*
  • Prodromal Symptoms
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy*
  • Retrospective Studies