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.
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 language | English |
|---|---|
| Pages (from-to) | 210-216 |
| Number of pages | 7 |
| Journal | British Journal of Psychiatry |
| Volume | 176 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2000 |