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Adolescent-onset psychosis: prevalence, needs and service provision

Young People’s Unit, Royal Edinburgh Hospital, Edinburgh

VAL MURRAY, MRCPsych

Gartnavel Royal Hospital, Glasgow

ANTHONY PELOSI, FRCPsych

Hairmyres Hospital, East Kilbride

ROBERT McCABE, MRCPsych

South Glasgow Adolescent and Family Psychiatry Service, Glasgow

DOUGLAS BLACKWOOD, FRCPsych

School of Molecular and Clinical Medicine, University of Edinburgh

ROBERT WRATE, FRCPsych

Young People’s Unit, Royal Edinburgh Hospital, Edinburgh, UK

Correspondence: Dr Leonie Boeing, Young People’s Unit, Royal Edinburgh Hospital, Tipperlinn Road, Edinburgh EH10 5HF, UK. Email: leonie.boeing{at}lpct.scot.nhs.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background Little is known of the epidemiology and care needs of people with adolescent-onset psychosis.

Aims To examine prevalence and the cross-sectional disability, needs and service provision for adolescent-onset psychosis in areas of central Scotland with a total population of 1.75 million.

Method We identified and contacted 103 young people using an opt-out research design. Fifty-three participants and their carers and keyworkers were interviewed using a modified version of the Cardinal Needs Schedule.

Results The 3-year prevalence was 5.9 per 100 000 general population. Twenty-one (20%) adolescents were not in contact with mental health services; 80% of first admissions were to adult acute psychiatric wards. Those interviewed had high levels of morbidity: 29 (55%) had serious to pervasive impairment of functioning; there were relatively high levels of side-effects, negative symptoms, anxiety, occupational, friendship and family difficulties. Care provision was better for‘clinical’than for‘social’domains; 20% had five or more unmet needs; 17% had at least one intractable problem.

Conclusions This low-prevalence disorder requires an assertive multi-agency approach in the context of a national planning framework.

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