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10-year outcome study of an early intervention program for psychosis compared with standard care service

Published online by Cambridge University Press:  19 September 2014

S. K. W. Chan ,
H. C. So ,
C. L. M. Hui ,
W. C. Chang ,
E. H. M. Lee ,
D. W. S. Chung ,
S. Tso ,
S. F. Hung ,
K. C. Yip  and
E. Dunn
...Show all authors
S. K. W. Chan*
Affiliation:
Department of Psychiatry, The University of Hong Kong, Hong Kong
H. C. So
Affiliation:
Department of Psychiatry, Queen Mary Hospital, Hong Kong
C. L. M. Hui
Affiliation:
Department of Psychiatry, The University of Hong Kong, Hong Kong
W. C. Chang
Affiliation:
Department of Psychiatry, The University of Hong Kong, Hong Kong
E. H. M. Lee
Affiliation:
Department of Psychiatry, The University of Hong Kong, Hong Kong
D. W. S. Chung
Affiliation:
Department of Psychiatry, Tai Po Hospital, Hong Kong
S. Tso
Affiliation:
Department of Psychiatry, Castle Peak Hospital, Hong Kong
S. F. Hung
Affiliation:
Department of Psychiatry, Kwai Chung Hospital, Hong Kong
K. C. Yip
Affiliation:
Department of Psychiatry, Kowloon Hospital, Hong Kong
E. Dunn
Affiliation:
Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital
E. Y. H. Chen
Affiliation:
Department of Psychiatry, The University of Hong Kong, Hong Kong The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
*
*Address for correspondence: Dr S. K. W. Chan, Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Room 219, New Clinical Building, 102 Pokfulam Road, Hong Kong. (Email: [email protected])
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Abstract

Background.

Despite evidence on the short-term benefits of early intervention (EI) service for psychosis, long-term outcome studies are limited by inconsistent results. This study examined the 10-year outcomes of patients with first-episode psychosis who received 2-year territory-wide EI service compared to those who received standard care (SC) in Hong Kong using an historical control design.

Method.

Consecutive patients who received the EI service between 1 July 2001 and 30 June 2002, and with diagnosis of schizophrenia-spectrum disorders, were identified and matched with patients who received SC first presented to the public psychiatric service from 1 July 2000 to 30 June 2001. In total, 148 matched pairs of patients were identified. Cross-sectional information on symptomatology and functioning was obtained through semi-structured interview; longitudinal information on hospitalization, functioning, suicide attempts, mortality and relapse over 10 years was obtained from clinical database. There were 70.3% (N = 104) of SC and 74.3% (N = 110) of EI patients interviewed.

Results.

Results suggested that EI patients had reduced suicide rate (χ2(1) = 4.35, p = 0.037), fewer number [odds ratio (OR) 1.56, χ2 = 15.64, p < 0.0001] and shorter duration of hospitalization (OR 1.29, χ2 = 4.06, p = 0.04), longer employment periods (OR −0.28, χ2 = 14.64, p < 0.0001) and fewer suicide attempts (χ2 = 11.47, df = 1, p = 0.001) over 10 years. At 10 years, no difference was found in psychotic symptoms, symptomatic remission and functional recovery.

Conclusions.

The short-term benefits of the EI service on number of hospitalizations and employment was sustained after service termination, but the differences narrowed down. This suggests the need to evaluate the optimal duration of the EI service.

Keywords

Early interventionpsychosis10-year outcomes
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1181 - 1193
Copyright
Copyright © Cambridge University Press 2014 

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