Journal Article

Three-year outcome comparison between extended early intervention and standard psychiatric care for adults with first-episode psychosis in Hong Kong

Ho, Matthew Tsz Ho, Chan, Sherry Kit Wa, Lau, Fu Chun, Chu, Ryan Sai Ting, Lee, Edwin Ho Ming, Chen, Eric, Lui, Tsz Ting, Hui, Christy Lai Ming, Chang, Wing Chung

2025

Overview

Early intervention (EI) for first-episode psychosis (FEP) mainly focuses on adolescents and young adults. Previous evaluation demonstrated superiority of 2-year EI program (EASY) over standard care in outcome improvement in young people (15-25 years) with FEP in Hong-Kong. However, effectiveness of territory-wide extended EASY, which provides 3-year EI service also to adult patients aged ≥26 years, has not been systematically examined. This study adopted historical control-case design, comparing patients aged 26-55 years who had received extended EI (EI-group,  = 160) with those managed by standard psychiatric care (SC-group,  = 160) prior to an implementation of extended EI service on a comprehensive range of outcomes encompassing duration of untreated psychosis (DUP), pathway to care, symptom severity, psychosocial functioning, subjective quality of life and service utilization over 3 years of psychiatric follow-up, using systematic medical-record review and follow-up interview assessment. Our results showed that EI-group had significantly shorter DUP than SC-group. Additionally, EI-group displayed fewer average positive symptoms in the first and second year of follow-up, lower levels of negative and depressive symptoms, better global and social functioning, and higher quality of life on physical domain than SC-group at 3 years of follow-up. Our findings indicate that adult FEP patients receiving 3-year extended EI service had better clinical and functional outcomes than those managed by standard psychiatric care. Our results thus provide real-world evidence supporting the superiority and implementation of 3-year extended EASY program for adult FEP patients in shortening of treatment delay and improvement of symptom and functional outcomes.

• Publisher: Cambridge University Press
• Subject: Adolescents / Adult / Adults / Bipolar disorder / Case studies / Case-Control Studies / Data collection / Dominance / Early intervention / Early Medical Intervention - methods / Emotional intelligence / Female / Follow-Up Studies / Functional impairment / Groups / Hong Kong / Humans / Intervention / Male / Medical records / Medical treatment / Mental depression / Mental disorders / Mental health services / Mental Health Services - statistics & numerical data / Middle Aged / Mortality / Original / Outcome Assessment, Health Care / Patients / Psychiatrists / Psychosis / Psychosocial factors / Psychosocial functioning / Psychotic Disorders - therapy / Quality of care / Quality of Life / Schizophrenia / Social functioning / Social interactions / Subjectivity / Symptoms / Treatment Outcome / Young adults / Youth