Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun;12(3):348-354.
doi: 10.1111/eip.12322. Epub 2016 Mar 28.

First episode psychosis in the over 35 s: is there a role for early intervention?

Philippa Greenfield  1 , Snehita Joshi  1 , Suneel Christian  1 , Petros Lekkos  1 , Anna Gregorowicz  1 , Helen L Fisher  2 , Sonia Johnson  1   3
Affiliations

First episode psychosis in the over 35 s: is there a role for early intervention?

Philippa Greenfield et al. Early Interv Psychiatry. 2018 Jun.

Abstract

Aim: The early intervention (EI) model appears to improve outcomes of psychosis for younger people, and there is now interest in implementing it in older groups. In the UK, the National Institute of Clinical Excellence advised that EI should be accessible to all individuals with first episode psychosis (FEP). We aimed to explore the likely impact on EI workloads and clinical populations of extending age range.

Methods: Data were collected on all patients aged 36-65 years who were referred to an inner London EI service from 2011-2014 using the MiData 2 tool at entry and at 1-year follow up.

Results: People aged between 36 and 65 represented 30% of all referrals to the service. There were high levels of recorded past trauma in the sample (62.5%), half had dependent children (58.3%) and just under half physical comorbidity (48.6%). Duration of untreated psychosis was less than a year for the majority. At 1-year follow up, inpatient admission rates were lower than in previously studied younger EI populations, but only 15% experienced a single episode with full remission.

Conclusions: These findings indicate that admitting over 35-year-olds to EI results in a substantial increase in workload. A large proportion had become unwell relatively recently, indicating that the concept of EI may not be redundant in this age range. Evidence is needed on EI effectiveness in this group.

Keywords: early intervention; older patients; outcome; psychosis.

PubMed Disclaimer

References

    1. Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells‐Ambrojo M et al. The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 2004; 329: 1067. - PMC - PubMed
    1. Petersen L, Jeppesen P, Thorup A et al. A randomised multicenter trial of integrated versus standard treatment for patients with a first episode of psychotic illness. BMJ 2005; 331: 602. - PMC - PubMed
    1. Garety PA, Craig TKJ, Dunn G et al Specialised care for early psychosis: symptoms, social functioning and patient satisfaction. Randomised controlled trial. Br J Psychiatry 2006; 188: 37–45. - PubMed
    1. Melle I, Larsen TK, Haahr U, Friis S et al Prevention of negative symptom psychopathologies in first‐episode schizophrenia: two‐year effects of reducing the duration of untreated psychosis. Arch Gen Psychiatry 2008; 65: 634–40. - PubMed
    1. McCrone P, Craig TKJ, Power P, Garety PA. Cost‐effectiveness of an early intervention service for people with psychosis. Br J Psychiatry 2010; 196: 377–82. - PubMed

Publication types