A narrative analysis investigating the impact of first episode psychosis on siblings’ identity

Background: One-third of individuals with schizophrenia have treatment-resistant illness. Of these, up to 60% will respond to clozapine treatment. Aims: This study retrospectively examined clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines as treatment-resistant illness emerged in a first-episode psychosis cohort. Methods: A total of 339 individuals with a first-episode psychosis were included in the study. Clozapine prescribing patterns were compared against the NICE guidelines and the impact of clozapine use on one index of service utilisation (hospitalisation) was assessed. Results: A total of 32 individuals (9.4%) from the cohort were prescribed clozapine. The mean time to clozapine trial was 2.1 years (SD 1.95; range 0.17–6.25). The mean number of adequate trials of antipsychotic prior to starting clozapine was 2.74 (SD 1.13; range 1–5). Following clozapine initiation, mean hospital admissions per year reduced from 2.3 to 0.3 ( p=0.00). Mean hospital days pre- and post-clozapine also reduced (147 vs. 53; p=0.00). In total, 18 patients discontinued clozapine use during follow-up – 5 temporarily and 13 permanently. Conclusions: Patients are being prescribed clozapine earlier than previously demonstrated, though delays are still evident, and many patients discontinue treatment. More work needs to be undertaken to understand and address factors which lead to its discontinuation.

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HIV seropositivity in patients with first-episode psychosis

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v13i3.22 ◽

2007 ◽

Vol 13 (3) ◽

pp. 4 ◽

Cited By ~ 2

Author(s):

S Mashaphu ◽

D L Mkize

Keyword(s):

Psychotic Disorders ◽

First Episode Psychosis ◽

First Episode ◽

Seroprevalence Rate ◽

Hiv Seropositivity ◽

Cross Sectional ◽

Causal Direction ◽

Episode Psychosis ◽

Kwazulu Natal ◽

The Impact

Background. In order to gauge the impact of the HIV epidemic on psychotic disorders, the magnitude and causal direction of the association between HIV infection and psychosis need to be examined closely.Objective. To determine the HIV seropositivity rate among adult patients presenting with first-episode psychosis (FEP) to Town Hill Hospital in Pietermaritzburg, KwaZulu-Natal.Design. A cross-sectional, point-prevalence study was done over a 6-month period.Results. Of the 63 FEP patients in the study, 48 tested HIV- negative and 15 tested positive, giving a seroprevalence rate of 23.8%.Conclusion. The prevalence of HIV seropositivity is high among patients with FEP.

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FC5E THE IMPACT OF AN EARLY DETECTION TEAM (LEO CAT) AND GP EDUCATION IN FIRST EPISODE PSYCHOSIS

Schizophrenia Research ◽

10.1016/s0920-9964(06)70122-0 ◽

2006 ◽

Vol 86 ◽

pp. S41 ◽

Cited By ~ 2

Author(s):

P. Power ◽

N. Reynolds ◽

H. Fisher ◽

E. Iacoponi ◽

P. Garety ◽

...

Keyword(s):

Early Detection ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

The Impact

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Poster #234 THE IMPACT OF TRAUMA IN CHILDHOOD AND ADULTHOOD ON CLINICAL AND SOCIAL FUNCTIONING IN FIRST EPISODE PSYCHOSIS

Schizophrenia Research ◽

10.1016/s0920-9964(12)71066-6 ◽

2012 ◽

Vol 136 ◽

pp. S365

Author(s):

Helen J. Stain ◽

Inge Joa ◽

Tor K. Larsen ◽

Jan Olav Johannessen ◽

Wenche ten Velden Hegelstad ◽

...

Keyword(s):

Social Functioning ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

The Impact

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Layers of listening: Qualitative analysis of the impact of early intervention services for first-episode psychosis on carers' experiences

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.146415 ◽

2015 ◽

Vol 207 (2) ◽

pp. 135-142 ◽

Cited By ~ 23

Author(s):

Anna Lavis ◽

Helen Lester ◽

Linda Everard ◽

Nicholas Freemantle ◽

Tim Amos ◽

...

Keyword(s):

Early Intervention ◽

Young People ◽

Help Seeking ◽

Young Person ◽

First Episode Psychosis ◽

First Episode ◽

Early Intervention Services ◽

Episode Psychosis ◽

Intervention Services ◽

The Impact

BackgroundEarly intervention services (EIS) comprise low-stigma, youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice.AimsBy analysing carers' accounts of their daily lives and affective challenges during a relative's FEP against the background of wider research into EIS, this paper explores relationships between carers' experiences and EIS.MethodSemi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS.ResultsOur data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these user-focused engagements also emerge; they risk leaving carers' emotions unacknowledged and compounding an existing lack of help-seeking.ConclusionsBy focusing on EIS's engagements with carers, this paper draws attention to an urgent broader question: as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?

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P03-137 - The impact of therapeutic options in first episode psychosis

European Psychiatry ◽

10.1016/s0924-9338(10)71106-8 ◽

2010 ◽

Vol 25 ◽

pp. 1117

Author(s):

I. Stoica ◽

M. Ienciu

Keyword(s):

First Episode Psychosis ◽

Therapeutic Options ◽

First Episode ◽

Episode Psychosis ◽

The Impact

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The Impact of Smoking on Clinical Outcomes After First Episode Psychosis: Longer-Term Outcome Findings From the EPPIC 800 Follow-Up Study

Journal of Dual Diagnosis ◽

10.1080/15504263.2010.537498 ◽

2010 ◽

Vol 6 (3-4) ◽

pp. 212-234 ◽

Cited By ~ 5

Author(s):

Michael Berk ◽

Lisa P. Henry ◽

Kathryn S. Elkins ◽

Susy M. Harrigan ◽

Meredith G. Harris ◽

...

Keyword(s):

Clinical Outcomes ◽

First Episode Psychosis ◽

First Episode ◽

Term Outcome ◽

Follow Up Study ◽

Episode Psychosis ◽

The Impact

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The impact of peri-natal stress on psychosis risk: results from the Bo-FEP incidence study

10.21203/rs.2.20997/v1 ◽

2020 ◽

Author(s):

Tiziano De Matteis ◽

Giuseppe D'Andrea ◽

Jatin Lal ◽

Domenico Berardi ◽

Ilaria Tarricone

Keyword(s):

Incidence Study ◽

Catchment Area ◽

Maternal Education ◽

Health Centre ◽

First Episode Psychosis ◽

First Episode ◽

Environment Interaction ◽

Episode Psychosis ◽

Study Results ◽

The Impact

Abstract Objective: According to the gene-environment interaction model the pathogenesis of psychosis relies on an adverse neuro-socio-developmental pathway. Perinatal stress represents an important risk factor for the development of psychosis because of the increasingly evident interference with socio-neuro-development in the earlier phases of life. We aim to investigate the correlation of perinatal risk factors with the onset of psychosis with a case-control – incidence study. Results: Patients (and their mothers) were eligible if they presented with first-episode psychosis at the Bologna West Community Mental Health Centre (Bo-West CMHC) between 2002 and 2012. The Bo-West CMHC serves a catchment area of about 200,000 people. The controls were recruited in the same catchment area and study period. 42 patients, 26 controls and their mothers were included. We collected the history of peri-natal stress and calculated crude and adjusted Odds Ratios for onset of first-episode psychosis. Adjusted logistic regression showed that psychosis onset was significantly associated with stressful situations during pregnancy, lower level of maternal physical health before or during pregnancy, use of anti-inflammatory drugs during pregnancy, and low level of maternal education. The results of our study suggest that stress during perinatal period increases the risk of developing psychosis.

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COVID and early intervention: the impact of COVID-19 on referrals to an early intervention service

BJPsych Open ◽

10.1192/bjo.2021.329 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S112-S112

Author(s):

Adam Whyte ◽

Alastair Reid

Keyword(s):

Mental Health ◽

Early Intervention ◽

Mental Health Services ◽

Health Services ◽

First Episode Psychosis ◽

First Episode ◽

Intervention Service ◽

Number Of Patients ◽

Episode Psychosis ◽

The Impact

AimsCOVID-19 has a demonstratable impact on the population's mental health and is associated with an increased incidence of psychiatric disorders, including patients experiencing psychotic presentations. The aim of this study was to explore whether referral rates within a county-wide Early Intervention (EI) service changed in response to the COVID-19 pandemic. The EI service provides NICE approved treatments and support for patients experiencing a First Episode Psychosis (FEP).MethodData were collected from all referrals to the EI service between March–December 2019 and March–December 2020. Clinical notes were reviewed to ascertain whether the referred patient was assessed and if they were subsequently accepted on to the team's caseload.ResultDuring the March–December 2019 period 147 referrals were made to the EI service, with 66 patients being accepted for treatment by the service (44.9% of referrals). In March–December 2020, 127 referrals were made, a 13.6% reduction compared to the same period in 2019, however 70 referrals were accepted (55.1% of referrals).Whilst the overall referrals declined during the COVID-19 period, there were notable increases in both April and August 2020, by 25.0% and 70.0% respectively.ConclusionAlthough overall referrals to the EI service reduced during the COVID-19 pandemic compared similarly to the previous year, there was a noteworthy increase in the proportion of patients accepted onto the team's caseload.Potential explanations for this finding include the possibility of an increased incidence of first episode psychosis during this period, or that restrictions in accessing primary care and secondary mental health services during the COVID-19 pandemic reduced the number of patients being referred whose symptoms were not representative of First Episode Psychosis (FEP).This study highlights that mental health services, such as EI teams, have experienced a persistent level of need over the past year and that ongoing investment in psychiatric services is warranted to meet this sustained requirement for support and interventions.

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