Journal Article

Only a small proportion of patients with first episode psychosis come via prodromal services: a retrospective survey of a large UK mental health programme

David, Anthony S., Williamson, Jessica, Gayer-Anderson, Charlotte, Dazzan, Paola, Murray, Robin M., Morgan, Craig, Oduola, Sherifat, Bourque, François, Ajnakina, Olesya, Bramley, Sally, MacCabe, James H.

2017

Overview

Background Little is known about patients with a first episode of psychosis (FEP) who had first presented to prodromal services with an “at risk mental state” (ARMS) before making the transition to psychosis. We set out to identify the proportion of patients with a FEP who had first presented to prodromal services in the ARMS state, and to compare these FEP patients with FEP patients who did not have prior contact with prodromal services. Methods In this study information on 338 patients aged ≤37 years who presented to mental health services between 2010 and 2012 with a FEP was examined. The data on pathways to care, clinical and socio-demographic characteristics were extracted from the Biomedical Research Council Case Register for the South London and Maudsley NHS Trust. Results Over 2 years, 14 (4.1% of n  = 338) young adults presented with FEP and had been seen previously by the prodromal services. These ARMS patients were more likely to enter their pathway to psychiatric care via referral from General Practice, be born in the UK and to have had an insidious mode of illness onset than FEP patients without prior contact with the prodromal services. Conclusions In the current pathways to care configuration, prodromal services are likely to prevent only a few at-risk individuals from transitioning to psychosis even if effective preventative treatments become available.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / At risk mental state / Care and treatment / Episode of Care / Female / First episode psychosis / Health care / Health services / Humans / Illnesses / Male / Medicine / Medicine & Public Health / Mental Health / Mental Health Services / Pathways to care / Prevalence studies (Epidemiology) / Prodromal services / Prodromal Symptoms / Psychiatry / Psychosis / Psychotherapy / Psychotic disorders / Psychotic Disorders - diagnosis / Psychotic Disorders - psychology / Research Article / Retrospective / Retrospective Studies / Risk factors / Schizophrenia / Services / Social psychiatry / Sociodemographics / Surveys and Questionnaires / therapy and provision of mental health care / Transition to psychosis / Treatment Outcome / United Kingdom / Young Adult