Ten-year outcome study of an early intervention programme for Psychosis compared with standard service

Abstract

BACKGROUND: Despite evidence on the short-term benefits of early intervention (EI) service for psychosis, long-term outcome studies are limited with inconsistent results. The current study examined the 10-year outcomes of patients with first-episode psychosis who received 2-year territory-wide EI service compared with those who received standard care (SC) in Hong Kong using an historical control design. METHODS: Consecutive patients who received the EI service between 1 July 2001 and 30 June 2002, and with diagnosis of schizophrenia-spectrum disorders, were identified and matched with patients who received SC first presented to the public psychiatric service from 1 July 2000 to 30 June 2001. A total of 148 matched pairs of patients were identified. Cross-sectional information on symptomatology and functioning was obtained through semi-structured interview; longitudinal information on hospitalisation, functioning, suicide attempts, mortality, and relapse over 10 years was obtained from clinical database. Overall, 70.3% (n = 104) of SC and 74.3% (n = 110) of EI patients were interviewed. RESULTS: Results suggested that EI patients had reduced suicide rate (χ2 (1) = 4.35, p = 0.037), fewer number (odds ratio [OR] = 1.56, χ2 = 15.64, p < 0.0001) and shorter duration of hospitalisations (OR = 1.29, χ2 = 4.06, p = 0.04), longer employment periods (OR = –0.28, χ2 = 14.64, p < 0.0001), and less suicide attempts (χ2 = 11.47, df = 1, p = 0.001) over 10 years. At 10 years, no difference was found in psychotic symptoms, symptomatic remission, and functional recovery. CONCLUSION: The short-term benefits of EI service on number of hospitalisations and employment sustained after service termination, but the differences narrowed down. This suggested the need of evaluating the optimal duration of EI service.