The Hong Kong Outcome of Psychosis Evaluation (HOPE) Study: a naturalistic longitudinal study of Early Intervention Service

Abstract

OBJECTIVES: In 2011, the Hospital Authority of Hong Kong extended the early psychosis service to cover older adults up to the age of 64 years. Our study group aimed to define the longitudinal outcomes of patients entering the early intervention service and their associated factors in our locality. METHODS: Consecutive patients aged 15 to 64 years presenting with first-episode psychosis to the early intervention services of Kwai Chung Hospital and Queen Mary Hospital were recruited. Psychopathology and functioning levels were assessed using standard instruments. Subjects were reassessed at 6 months, 1 year, 2 years, and 3 years after entry into our service. RESULTS: Since 1 February 2013, 170 subjects with valid data were recruited. More than half (57.4%) suffered from schizophrenia. Around half of them (55.9%) received psychiatric treatment before service contact. The mean scores for Positive and Negative Syndrome Scale positive, negative, cognitive, depressive, and excitement were 14.9, 11.1, 8.1, 7.7, and 4.7, respectively. The mean score for Scale for the Assessment of Negative Symptoms was 5.5. The means for Social and Occupational Functioning Assessment Scale (SOFAS) and Role Functioning Scale (RFS) were 54.5 and 22.3, respectively. Valid data at 6 months were available for 79 subjects. Subjects had significant improvements in all symptom domains except negative symptoms, manic symptoms, and insight. They also had significant improvements in functioning, with mean SOFAS of 63.2 (t = –5.286, p < 0.001) and RFS of 24.1 (t = –3.870, p < 0.001). Seventeen (21.5%) subjects suffered from some degree of relapse within the period. CONCLUSION: This is a systematic attempt to study the longitudinal outcomes of people suffering from first-episode psychosis in Hong Kong. Further data will be collected to enrich the database.