Three-year outcome of first-episode psychoses in an established community psychiatric service

Swaran P. Singh (Lead / Corresponding author), Tim Croudace, Shazad Amin, Rosemary Kwiecinski, Ian Medley, Peter B. Jones, Glynn Harrison

    Research output: Contribution to journalArticlepeer-review

    58 Citations (Scopus)

    Abstract

    Background Changes in service provision, secular trends in substance misuse and changing social structures might affect outcome in psychosis.
    Aims To assess the three-year outcome of an inception cohort of first-episode psychoses treated in a modern, community-oriented service; to compare outcomes with an earlier cohort treated in hospital-based care; and to examine the predictive validity of ICD—10 diagnostic criteria.
    Method Three-year follow-up (1995-1997) of an inception cohort of first-episode psychoses and comparison with two-year follow-up (1980-1982) of the Determinants of Outcome of Severe Mental Disorders (DOSMED) Nottingham cohort.
    Results On most outcome measures, non-affective psychoses had a worse outcome than affective psychoses. Affective psychoses had better outcome than previously reported. Substance-related psychoses had very poor occupational outcome. Similar proportions of the current and DOSMED cohort were in remission but the former were rated as having greater disability.
    Conclusions In a modern community service, 30-60% of patients with first-episode psychoses experience a good three-year outcome. The ICD—10 criteria have good predictive validity.
    Original languageEnglish
    Pages (from-to)210-216
    Number of pages7
    JournalBritish Journal of Psychiatry
    Volume176
    Issue number3
    DOIs
    Publication statusPublished - Mar 2000

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