Services for people at high risk improve outcomes in patients with first episode psychosis

Objective: About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services. Method: Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders. Results: FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: - 33.7 to (- 0.3)], had a shorter referralto- diagnosis time [B coefficient - 74.5 days, 95% CI: - 101.9 to - (47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.390.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34-0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services. Conclusion: Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.