Cardiff and Vale University Health Board, Whitchurch Hospital, Park Road, Cardiff, UK.
Early Interv Psychiatry. 2013 Aug;7(3):311-4. doi: 10.1111/eip.12028. Epub 2013 Jan 24.
The aims of this study were to determine medium-term outcomes of a cohort of early intervention service users after discharge from the service. Additionally, to establish whether characteristics can be easily identified in the early stages of treatment to predict outcome, aid discharge planning and focus interventions.
One hundred fifty-five early intervention service users were followed-up for a mean of 4.6 years from the start of early intervention treatment. Patients were divided into good and poor outcome groups and these groups were compared on gender, duration of untreated psychosis, age at first presentation to mental health services, hospital admissions in the first year and time spent on the waiting list.
A third of the patients had a good outcome, with a discharge to primary care and no subsequent return to mental health services. Good outcome was associated with a later age of first contact with mental health services and fewer hospital admissions in the first year of treatment.
We would suggest that clinicians working in this and similar services could use these two factors as early as one year into treatment to begin to consider discharge planning, or conversely to focus resources most appropriately on those likely to benefit most or those who have the greatest predicted need. This study supports an optimist view of prognosis for a significant proportion of first-episode psychosis patients.
本研究旨在确定早期干预服务使用者在出院后的中期结局。此外，还需要确定在治疗的早期阶段是否可以容易地识别出特征，以便预测结果、辅助出院计划和聚焦干预措施。
155 名早期干预服务使用者在接受早期干预治疗后，平均随访了 4.6 年。将患者分为预后良好组和预后不良组，并比较两组的性别、未治疗的精神病持续时间、首次就诊于精神卫生服务的年龄、入院次数和等待名单上的时间。
三分之一的患者预后良好，出院后进入初级保健，随后未返回精神卫生服务。良好的预后与首次接触精神卫生服务的年龄较晚和治疗第一年的入院次数较少有关。
我们建议，在这类服务中工作的临床医生可以在治疗的第一年就使用这两个因素开始考虑出院计划，或者相反，将资源最恰当地集中在那些最有可能受益或最需要的人身上。本研究支持了对大多数首发精神病患者有一个乐观的预后看法。
