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First episode psychosis in the over 35s: is there a role for early intervention?

Greenfield, P; Joshi, S; Christian, S; Lekkos, P; Gregorowicz, A; Fisher, HL; Johnson, S; (2016) First episode psychosis in the over 35s: is there a role for early intervention? Early Intervention in Psychiatry 10.1111/eip.12322. (In press). Green open access

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Abstract

AIM: The early intervention (EI) model appears to improve outcomes of psychosis for younger people, and there is now interest in implementing it in older groups. In the UK, the National Institute of Clinical Excellence advised that EI should be accessible to all individuals with first episode psychosis (FEP). We aimed to explore the likely impact on EI workloads and clinical populations of extending age range. METHODS: Data were collected on all patients aged 36-65 years who were referred to an inner London EI service from 2011-2014 using the MiData 2 tool at entry and at 1-year follow up. RESULTS: People aged between 36 and 65 represented 30% of all referrals to the service. There were high levels of recorded past trauma in the sample (62.5%), half had dependent children (58.3%) and just under half physical comorbidity (48.6%). Duration of untreated psychosis was less than a year for the majority. At 1-year follow up, inpatient admission rates were lower than in previously studied younger EI populations, but only 15% experienced a single episode with full remission. CONCLUSIONS: These findings indicate that admitting over 35-year-olds to EI results in a substantial increase in workload. A large proportion had become unwell relatively recently, indicating that the concept of EI may not be redundant in this age range. Evidence is needed on EI effectiveness in this group.

Type: Article
Title: First episode psychosis in the over 35s: is there a role for early intervention?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/eip.12322
Publisher version: http://dx.doi.org/10.1111/eip.12322
Additional information: © 2016 The Authors. Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: early intervention, older patients, outcome, psychosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1481759
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