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

Singh, Swaran P.; Croudace, Tim; Shazad Amin; Kwiecinski, Rosemary; Medley, Ian; Jones, Peter B.; Harrison, Glynn; Singh, S P; Croudace, T; Amin, S; Kwiecinski, R; Medley, I; Jones, P B; Harrison, G
March 2000
British Journal of Psychiatry;Mar2000, Vol. 176, p210
Academic Journal
journal article
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.


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