© 2001 The Royal College of Psychiatrists
Patterns and predictors of hospitalisation in first-episode psychosis
Prospective cohort study
Division of Psychiatry, University of Bristol, Bristol
Department of Social Medicine, University of Bristol, Bristol
Trafford General Hospital, Manchester
Queen's Medical Centre, Nottingham
Correspondence: Dr Attila Sipos, Division of Psychiatry, University of Bristol, 41 St Michael's Hill, Bristol BS 2 8 DZ; e-mail: Attila.Sipos{at}bristol.ac.uk
Declaration of interest Funded by NHS Executive Trent Research and Development.
Background Little is known about predictors of hospitalisation in patients with first-episode psychosis.
Aims To identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.
Method Three-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.
Results Eighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.
Conclusions Community-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.
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