Fordham Eliza, Gao Caroline X, Filia Kate, O'Donoghue Brian, Smith Catherine, Francey Shona, Rickwood Debra, Telford Nic, Thompson Andrew, Brown Ellie
Orygen, Parkville, Australia; Centre for Youth Mental Health, University of Melbourne, Australia.
Orygen, Parkville, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
Psychiatry Res. 2023 Oct;328:115478. doi: 10.1016/j.psychres.2023.115478. Epub 2023 Sep 10.
Incidence of psychosis varies geographically due to factors such as social disadvantage. Whether this influences the clinical presentation and/or engagement of those experiencing psychosis remains relatively understudied. This study analysed data from young people across Australia accessing ultra-high risk (UHR) or first episode psychosis (FEP) services delivered through the headspace Early Psychosis (hEP) program between June 2017 and March 2021. The cohort was categorised into low, middle, and high tertiles of social disadvantage using the Index of Relative Socioeconomic Disadvantage (IRSD). Data from 3089 participants aged 15-25 were included (1515 UHR, 1574 FEP). The low and middle tertiles for both cohorts had greater percentages of those not in education or employment (NEET), with First Nations or culturally and linguistically diverse backgrounds. Clinical presentations to services were similar across all tertiles in both cohorts, however, functioning at presentation varied significantly within the FEP cohort. Significantly lower numbers of direct services were provided in the low tertile of both cohorts, with significantly poorer engagement in the initial three-months also occurring for these young people. This variation in early psychosis service patterns associated with geographical variation in social deprivation demonstrates the need for further research and fine tuning of national early psychosis services.
由于社会劣势等因素，精神病的发病率在地理上存在差异。这是否会影响精神病患者的临床表现和/或参与度仍相对缺乏研究。本研究分析了2017年6月至2021年3月期间，澳大利亚各地通过headspace早期精神病（hEP）项目获得超高风险（UHR）或首次发作精神病（FEP）服务的年轻人的数据。使用相对社会经济劣势指数（IRSD）将该队列分为社会劣势的低、中、高三分位组。纳入了3089名年龄在15 - 25岁之间的参与者的数据（1515名UHR，1574名FEP）。两个队列的低三分位组和中三分位组中，未接受教育或就业（NEET）的、具有原住民或文化和语言背景多样的人群比例更高。两个队列中所有三分位组向服务机构的临床表现相似，然而，FEP队列中就诊时的功能存在显著差异。两个队列的低三分位组提供的直接服务数量显著更少，这些年轻人在最初三个月的参与度也显著更低。这种与社会剥夺地理差异相关的早期精神病服务模式的差异表明，需要对国家早期精神病服务进行进一步研究和微调。
