Short-term compliance in first-episode psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. s254-s255 ◽  
Author(s):  
N. Iriarte Yoller ◽  
J. Vicente García ◽  
F. Rico Villademoros

IntroductionNon-compliance is a significant problem in patients with first-episode psychosis (FEP), representing a challenge for mental health professionals due to the heterogeneous course and functional outcomes.ObjectivesThe aim was to describe the short-term compliance in FEP and analyze the demographics, clinical features, and management issues potentially associated with non-compliance.MethodsThis observational and retrospective study included all consecutive FEP admitted to our psychiatry unit from January to June 2015, belonging to our catchment area. To be categorized as compliant, patients had to attend month-1 and month-3 follow-up visits. Characteristics of compliant and non-compliant were compared using a bivariate analysis.ResultsWe included 18 patients whose characteristics are shown in the table. Overall, 8 (44.4%) were non-compliant. Patients who were non-compliant had a significantly shorter length of stay (10.3 [6.3] vs. 18.5 [8.9] days). Most patients (66.7%) had cannabis abuse, being slightly more frequent among non-compliant (75% vs. 60%, P = NS); in addition, the diagnosis of substance-induced psychotic disorder was also more common among non-compliant (50% vs 20%, P = NS). There were 2 patients who were readmitted, both in the non-compliant group (Table 1).ConclusionsShort-term non-compliance is high among patients with FEP. Despite the limitations of our study, our results suggest that, beside other factors (e.g. substance abuse), non-compliance could be associated with management-related factors.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2017 ◽  
Vol 41 (S1) ◽  
pp. S276-S276
Author(s):  
E. Pereira ◽  
M. Mota Oliveira ◽  
R. Guedes ◽  
M.J. Peixoto ◽  
I. Ferraz ◽  
...  

IntroductionRelapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.ObjectivesTo characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.MethodsA retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.ResultsFinal sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.ConclusionsAlthough no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2008 ◽  
Vol 40 (1) ◽  
pp. 63-72 ◽  
Author(s):  
M. Álvarez-Jiménez ◽  
J. F. Gleeson ◽  
S. M. Cotton ◽  
D. Wade ◽  
K. Crisp ◽  
...  

BackgroundLittle research has focused on delineating the specific predictors of emotional over-involvement (EOI) and critical comments (CC) in the early course of psychosis. The purpose of this study was to investigate the differential relationships of EOI and CC with relevant predictors in relatives of first-episode psychosis (FEP) patients.MethodBaseline patient-related factors including psychotic symptoms, depression and duration of untreated psychosis (DUP) and carer attributes comprising CC, EOI, burden of care and carers' stress and depression were assessed in a cohort of 63 remitted FEP patients and their relatives. Carers were reassessed at 7 months follow-up.ResultsBaseline analysis showed that EOI was more strongly correlated with family stress compared with CC, whereas CC yielded a stronger association with DUP than EOI. Carers' CC at follow-up was not significantly predicted by either baseline family stress, burden of care or patient-related variables. Conversely, baseline EOI predicted both family stress and burden of care at 7 months follow-up. Finally, family burden of care at follow-up was a function of baseline EOI and patients' depressive symptoms.ConclusionsThis study provides preliminary support to the postulate that EOI and CC may be influenced by separate factors early in the course of psychosis and warrant future research and therapeutic interventions as separate constructs. Implications for family interventions in the early phase of psychosis and the prevention of CC and EOI are discussed.


2017 ◽  
Vol 41 (S1) ◽  
pp. S99-S99
Author(s):  
P. Strålin ◽  
J. Hetta

IntroductionOutcome after first episode psychosis is heterogeneous, but knowledge about the distribution and predictive factors is limited.ObjectiveTo investigate medication and rehospitalizations for five years after first episode hospital treated psychosis.MethodSwedish population registers were used to select a nation-wide cohort of 962 cases (589 or 61% men) with a first hospitalization for psychosis at ages between 16–25 years. Cases were categorized year by year for 5 years after the initial hospitalization with regard to rehospitalizations and dispensations of antipsychotics and other medications.ResultsThe 5-years mortality was 4% (n = 39) with suicides in 16 cases (1.6%, 11 of which were men). Additionally, 139 cases (23% of women and 10% of men) had hospitalizations for suicide attempts within 5 years. A bimodal distribution of years with medication was found indicating two different trajectories of outcome. One peak was seen for cases with dispensations of antipsychotics 5 of 5 years (40% of the cohort). Another peak was seen at dispensations during at most 1 of 5 year (30%). During year 5, 514 (56% of 923 cases surviving 5 years) had dispensations of neuroleptics and 257 (28%) were hospitalized, whereas 356 cases (39%) had no dispensation of neuroleptics or hospitalization.ConclusionsThe population of young cases with first episode psychosis is heterogeneous with at least two clearly separable trajectories based on medication and hospitalizations. The high mortality and high incidence of suicide attempts during a five-year period demonstrate a need for careful monitoring of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. S587-S587 ◽  
Author(s):  
A. Toll ◽  
A. Mané ◽  
D. Bergé ◽  
V. Pérez-Solà

IntroductionThere are high rates of substance use disorders (SUD) amongst first episode psychosis (FEP). SUD have been linked to better premorbid adjustment, more severe positive and negative symptoms at presentation and poorer symptomatic and functional outcome [1]. Moreover, shorter duration of untreated psychosis (DUP) has been described as an important predictor of outcome in FEP [2].AimsWith this study, we want to know which baseline characteristics and clinical outcomes differ between FEP patients with and without substance use.MethodsOne hundred and seventy-five FEP were consecutively admitted to Hospital del Mar since January 2008 to September 2014 and entered the FEP programme of the institution. The included evaluation was socio-demographic and clinical data at baseline and 1 year follow-up. We studied differences in age, gender, DUP, GAF scores at baseline and 1 year follow-up and PANSS subscale scores at base and 1 year follow-up between substance users and non-users.ResultsCannabis: we found that users were significative younger (P < 0.01), had a higher proportion of males (P < 0.01) and a significative shorter DUP in users (P = 0.008).Alcohol: we found that users were significative younger (P < 0.009), had a higher proportion of males (P < 0.003) and a significative lower PANNS negative scores at baseline (P = 0.01) and 1 year follow-up (P = 0.03).ConclusionsIn our sample of first episode psychosis, cannabis and alcohol use is linked with a younger age and a high proportion of males. Moreover, it seems that cannabis use could be associated with a shorter DUP.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2010 ◽  
Vol 4 (2) ◽  
pp. 105-114 ◽  
Author(s):  
Tina Montreuil ◽  
Michael Bodnar ◽  
Marie-Claude Bertrand ◽  
Ashok Malla ◽  
Ridha Joober ◽  
...  

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.


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