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Conference Paper: Three-Year Outcome Comparison Between Patients Presenting With First-Episode Psychotic Mania And Schizophrenia To Easy Program In Hong Kong

TitleThree-Year Outcome Comparison Between Patients Presenting With First-Episode Psychotic Mania And Schizophrenia To Easy Program In Hong Kong
Authors
Issue Date2014
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schres
Citation
The 4th Biennial Schizophrenia International Research Conference, Florence, Italy, 5-9 April 2014. In Schizophrenia Research, 2014, v. 153 suppl. 1, p. S304-S305, poster #T44 How to Cite?
AbstractBACKGROUND: Early intervention for first-episode psychosis has been the focus of mental health care development worldwide in the past two decades. A majority of previous research focused mainly either on outcomes of a cohort of broad-spectrum psychotic disorders (first-episode psychosis) or patients with a more specific diagnostic entity, mostly schizophrenia. Despite the fact that bipolar affective disorder frequently occurs in late adolescence or early adulthood, and is associated with poor long-term functional impairment, relatively few studies have been conducted to examine the early course of the illness. In this study, we aimed to compare the 3-year clinical and functional outcomes between first-episode psychotic mania (FEPM) and first-episode schizophrenia (FES) in the context of early intervention program in Hong Kong. METHODS: Four hundred-twenty patients aged 15 to 25 years presenting with first-episode ICD-10 psychotic mania or schizophrenia to a territory wide early intervention service in Hong Kong, namely Early Assessment Service for Young people with psychosis (EASY) between July 2001 and August 2003 and completed 3-year follow-up were included in the study. Socio-demographics, baseline and follow-up variables were obtained via systematic retrospective medical record review following standardized protocol. Symptom (CGI-S) and functional outcome (SOFAS) measures were determined for each month in the 3 years following entry to EASY program. RESULTS: Of the 420 patients, 374 and 46 were diagnosed with FES and FEPM, respectively. At baseline, patients with FES had longer duration of untreated psychosis (DUP) (t=8.4, p<0.001), fewer hospitalization at entry (χ2=29.0, p<0.001), fewer positive symptoms (t=−2.6, p=0.01) and better functioning (t=3.5, p=0.001) than patients with FEPM. By the end of 3-year follow-up, FEPM patients had significantly fewer positive symptoms (t=2.8, p<0.05), fewer readmissions (t=−3.9, p<0.001), better functioning (t=−2.9, p<0.05), higher likelihood of achieving sustained employment (χ2=4.6, p<0.05) than FES patients. Multivariate regression analyses taking into consideration baseline between-diagnostic group differences revealed that diagnostic status (i.e., FEPM vs. FES) independently predicted total number of hospitalizations over 3 years (p<0.05), sustained employment (p<0.01), and global functional outcome at 3 years of follow-up (p<0.01). DISCUSSION: In a large representative cohort of Chinese young patients presenting with first-episode psychosis to early intervention service, our findings indicated that patients with FEPM had better 3-year clinical and functional outcomes than those with FES. More prospective research is required to investigate the longitudinal course and outcome predictors of bipolar affective disorder in its early illness stage.
Persistent Identifierhttp://hdl.handle.net/10722/197702
ISSN
2015 Impact Factor: 4.453
2015 SCImago Journal Rankings: 2.304

 

DC FieldValueLanguage
dc.contributor.authorChang, WCen_US
dc.contributor.authorLau, ESKen_US
dc.contributor.authorHui, CLMen_US
dc.contributor.authorChan, KWen_US
dc.contributor.authorLee, HMEen_US
dc.contributor.authorChen, EYHen_US
dc.date.accessioned2014-05-29T08:43:27Z-
dc.date.available2014-05-29T08:43:27Z-
dc.date.issued2014en_US
dc.identifier.citationThe 4th Biennial Schizophrenia International Research Conference, Florence, Italy, 5-9 April 2014. In Schizophrenia Research, 2014, v. 153 suppl. 1, p. S304-S305, poster #T44en_US
dc.identifier.issn0920-9964-
dc.identifier.urihttp://hdl.handle.net/10722/197702-
dc.description.abstractBACKGROUND: Early intervention for first-episode psychosis has been the focus of mental health care development worldwide in the past two decades. A majority of previous research focused mainly either on outcomes of a cohort of broad-spectrum psychotic disorders (first-episode psychosis) or patients with a more specific diagnostic entity, mostly schizophrenia. Despite the fact that bipolar affective disorder frequently occurs in late adolescence or early adulthood, and is associated with poor long-term functional impairment, relatively few studies have been conducted to examine the early course of the illness. In this study, we aimed to compare the 3-year clinical and functional outcomes between first-episode psychotic mania (FEPM) and first-episode schizophrenia (FES) in the context of early intervention program in Hong Kong. METHODS: Four hundred-twenty patients aged 15 to 25 years presenting with first-episode ICD-10 psychotic mania or schizophrenia to a territory wide early intervention service in Hong Kong, namely Early Assessment Service for Young people with psychosis (EASY) between July 2001 and August 2003 and completed 3-year follow-up were included in the study. Socio-demographics, baseline and follow-up variables were obtained via systematic retrospective medical record review following standardized protocol. Symptom (CGI-S) and functional outcome (SOFAS) measures were determined for each month in the 3 years following entry to EASY program. RESULTS: Of the 420 patients, 374 and 46 were diagnosed with FES and FEPM, respectively. At baseline, patients with FES had longer duration of untreated psychosis (DUP) (t=8.4, p<0.001), fewer hospitalization at entry (χ2=29.0, p<0.001), fewer positive symptoms (t=−2.6, p=0.01) and better functioning (t=3.5, p=0.001) than patients with FEPM. By the end of 3-year follow-up, FEPM patients had significantly fewer positive symptoms (t=2.8, p<0.05), fewer readmissions (t=−3.9, p<0.001), better functioning (t=−2.9, p<0.05), higher likelihood of achieving sustained employment (χ2=4.6, p<0.05) than FES patients. Multivariate regression analyses taking into consideration baseline between-diagnostic group differences revealed that diagnostic status (i.e., FEPM vs. FES) independently predicted total number of hospitalizations over 3 years (p<0.05), sustained employment (p<0.01), and global functional outcome at 3 years of follow-up (p<0.01). DISCUSSION: In a large representative cohort of Chinese young patients presenting with first-episode psychosis to early intervention service, our findings indicated that patients with FEPM had better 3-year clinical and functional outcomes than those with FES. More prospective research is required to investigate the longitudinal course and outcome predictors of bipolar affective disorder in its early illness stage.-
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/schres-
dc.relation.ispartofSchizophrenia Researchen_US
dc.titleThree-Year Outcome Comparison Between Patients Presenting With First-Episode Psychotic Mania And Schizophrenia To Easy Program In Hong Kongen_US
dc.typeConference_Paperen_US
dc.identifier.emailChang, WC: changwc@hku.hken_US
dc.identifier.emailHui, CLM: christyh@hkucc.hku.hken_US
dc.identifier.emailChan, KW: kwsherry@hku.hken_US
dc.identifier.emailLee, HME: edwinlhm@hku.hken_US
dc.identifier.emailChen, EYH: eyhchen@hku.hken_US
dc.identifier.authorityChang, WC=rp01465en_US
dc.identifier.authorityChan, KW=rp00539en_US
dc.identifier.authorityLee, HME=rp01575en_US
dc.identifier.authorityChen, EYH=rp00392en_US
dc.identifier.doi10.1016/S0920-9964(14)70861-8-
dc.identifier.hkuros229001en_US
dc.identifier.volume153en_US
dc.identifier.issuesuppl. 1en_US
dc.identifier.spageS304en_US
dc.identifier.epageS305en_US
dc.publisher.placeNetherlands-

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