Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-07T17:30:48.400Z Has data issue: false hasContentIssue false
  • English
  • Français

Frequency and predictors of adverse events

PRiSM Psychosis Study 3

Published online by Cambridge University Press:  02 January 2018

Sonia Johnson ,
Morven Leese ,
Liz Brooks ,
Paul Clarkson ,
Hilary Guite ,
Graham Thornicroft ,
Frank Holloway  and
Til Wykes
Sonia Johnson*
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London Medical School, London
Morven Leese
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Liz Brooks
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Paul Clarkson
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Hilary Guite
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London
Frank Holloway
Affiliation:
Maudsley Hospital, London
Til Wykes
Affiliation:
Department of Psychology, Institute of Psychiatry, London
*
Dr Sonia Johnson, Department of Psychiatry and Behavioural Sciences, University College London Medical School, 48 Riding House Street, London W1N 8AA
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Community care has been criticised as a hazardous policy associated with high rates of adverse events. There is little research evidence as to the truth of this claim.

Method

Best available evidence from public records, interviews, case notes, key workers and general practitioners was assembled to establish: (a) which of the 514 subjects initially identified as having psychotic illnesses had died during an average follow-up of 4.9 years; (b) care currently received by all 286 subjects originally selected for interview; and (c) rates of major adverse events and of admission for these 286 individuals.

Results

Twenty-eight natural and 11 unnatural deaths had occurred. Among subjects still living at the end of the follow-up, 84% were in contact with specialist mental health services and 11% only with primary care services. Rates of serious violence, imprisonment and homelessness were relatively low. Forty-one per cent had been admitted at least once during a mean follow-up of 3.2 years and 20% at least once under the Mental Health Act. After adjustment, there were no significant differences between standard and intensive care sectors.

Conclusions

Rates of adverse events and slipping through the net’ are relatively low among individuals receiving community-based services, whether intensive or standard care.

Type
PRiSM Psychosis Study
Information
The British Journal of Psychiatry , Volume 173 , Issue 5 , November 1998 , pp. 376 - 384
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Chariton, J., Kelly, S., Dunnell, K., et al (1993) Suicide deaths in England and Wales: trends in factors associated with suicide deaths. Population Trends, 71, 34–42.Google Scholar
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in risk of compulsory admission among representative cases of psychosis in London, British Medical Journal, 312, 533–537.CrossRefGoogle Scholar
Dayson, D. (1993) The TAPS Project. 12: Crime, vagrancy, death and readmission of the long-term mentally ill during their first year of local reprovision. British Journal of Psychiatry, 162 (suppl. 19), 40–44.Google Scholar
Harrison, G., Mason, P., Glazebrook, C., et al (1994) Residence of incident cohort of psychotic patients after 13 years of follow up. British Medical Journal, 308, 813–816.Google Scholar
Johnstone, E. (1990) What is crucial for the long-term outcome of schizophrenia? In Search for the Causes of Schizophrenia Volume II (eds Häfner, H. & Gattaz, W. F.). Heidelberg: Springer-Verlag.Google Scholar
Jones, S. H., Thornicroft, G., Coffey, M., et al (1995) A brief mental health outcome scale: reliability and validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry, 166, 654–659.CrossRefGoogle ScholarPubMed
Mason, P., Harrison, G., Glazebrook, C., et al (1995) Characteristics of outcome in schizophrenia at 13 years. British Journal of Psychiatry, 167, 596–603.Google Scholar
McGuffin, P., Farmer, A. & Harvey, I. (1991) A polydiagnostic application of operational criteria in studies in psychotic illness: development of reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.CrossRefGoogle ScholarPubMed
StataCorp (1995) Stata Statistical Software: Release 4.0. College Station. TX: Stata Corporation.Google Scholar
Wing, J. K., Bahor, T., Brugha, T., et al (1989) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589–593.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.