Effects Of First Psychiatric Admission On 3-year Outcome In Patients With First Episode Psychosis In Hong Kong

Abstract

Background: Psychotic disorders are among the 10 leading causes of disability-adjusted life years (DALYs). Increasing effort has been devoted in identifying factors and interventional strategies associated with better outcome. The Early Assessment Service for young people with psychosis (EASY) was launched in Hong Kong in 2001 aimed to provide early detec-tion and intensive intervention for people with fi rst-episode psychosis. This study compared the 3-year outcome of patients receiving the Early Intervention (EI) service with those who received standard care (SC) prior to the launch of the EI service. For the Early Intervention (EI) group, the impact of initial hospitalization was studied for effect on subsequent outcome.Methods: 700 patients with fi rst-episode psychosis consecutively enrolled in EASY programme were compared with 700 matched historical controls.Results: Fewer patients in the Early Intervention programme had been hospitalized at the fi rst month of treatment. Patients in the Early Interven-tion programme had fewer number of compulsory admissions, fewer number of subsequent admissions and had shorter duration of hospital stay compared with patients in historical control. Amongst patients in Early Intervention programme, those who were not hospitalized initially were found to have better functional outcome, fewer days in hospital, less suicide attempts.Discussion: The current study suggests that Early Intervention Programme in Hong Kong is successful in reducing the number of admission and dura-tion of hospitalization. Early Intervention programme should aim for community treatment and to minimize the initial hospitalization in order to bring better outcome