© 2000 The Royal College of Psychiatrists
Three-year outcome of first-episode psychoses in an established community psychiatric service
Division of Psychiatry, University of Nottingham
Division of Psychiatry, University of Bristol
Declaration of interest Funded by NHS Executive Trent R & D and the Stanley Foundation. T.C. was supported by the Medical Research Council.
Correspondence: Dr Swaran P. Singh, Department of Psychiatry, B Floor, South Block, University Hospital, Nottingham NG7 2UH
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.
This article has been cited by other articles:
 |
|
 |
|
  P. Byrne Managing the acute psychotic episode BMJ, March 31, 2007; 334(7595): 686 - 692. [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Singh, T. Burns, S. Amin, P. B. Jones, and G. Harrison Acute and transient psychotic disorders: precursors, epidemiology, course and outcome The British Journal of Psychiatry, December 1, 2004; 185(6): 452 - 459. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rinaldi, K. Mcneil, M. Firn, M. Koletsi, R. Perkins, and S. P. Singh What are the benefits of evidence-based supported employment for patients with first-episode psychosis? Psychiatr. Bull., August 1, 2004; 28(8): 281 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. RUGGERI, A. LASALVIA, M. TANSELLA, C. BONETTO, M. ABATE, G. THORNICROFT, L. ALLEVI, and P. OGNIBENE Heterogeneity of outcomes in schizophrenia: 3-year follow-up of treated prevalent cases The British Journal of Psychiatry, January 1, 2004; 184(1): 48 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Singh, C. Wright, T. Burns, E. Joyce, and T. R. E. Barnes Developing early intervention services in the NHS: a survey to guide workforce and training needs Psychiatr. Bull., July 1, 2003; 27(7): 254 - 258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. SIPOS, G. HARRISON, D. GUNNELL, S. AMIN, and S. P. SINGH Patterns and predictors of hospitalisation in first-episode psychosis: Prospective cohort study The British Journal of Psychiatry, June 1, 2001; 178(6): 518 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Whitwell Service innovations: early intervention in psychosis as a core task for general psychiatry Psychiatr. Bull., April 1, 2001; 25(4): 146 - 148. [Full Text]
|
|
|
|
 |
|
 S. P. Singh Running an effective community mental health team Adv. Psychiatr. Treat., November 1, 2000; 6(6): 414 - 422. [Full Text]
|
|