First-episode psychosis: Ongoing mental health service utilization during the stable period for adolescents

Robin E. Gearing, Kathryne B. Brewer, Irfan Mian, Kiara L. Moore, Prudence Fisher, Jane Hamilton, James Mandiberg

    Research output: Contribution to journalArticle

    Abstract

    Aim: The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode psychosis (FEP), but has received less research attention. In this study, variables that could impact continued psychiatric service utilization by adolescents following their FEP and temporal patterns in service utilization are examined. Methods: Families of 52 adolescents (aged 14.4 ± 2.5 years) discharged following a hospitalization for FEP were contacted two or more years following the adolescents’ discharge. A chart review (Time 1) of hospital records provided clinical data on each adolescent's psychiatric diagnosis, symptoms, illness course, medications and family history. Follow-up (Time 2) data were collected from parents/caregivers using a questionnaire enquiring about post-discharge treatment history and service utilization. Results: Bivariate analyses were conducted to identify Time 1 variables associated with psychiatric service utilization at Time 2. Significant variables were included in a logistic regression model and three variables were independently associated with continued service utilization: having a primary diagnosis of schizophrenia (odds ratio (OR) = 24.0; P = 0.02), not having a first-degree relative with depression (OR = 0.12; P = 0.05) and fewer months since the last inpatient discharge (OR = 0.92; P = 0.02). Conclusions: Findings suggest: (1) the importance of early diagnosis, (2) that a relative with depression may negatively influence the adolescent's ongoing service utilization, and (3) that 18 months post-discharge may be a critical time to review treatment strategies and collaborate with youth and families to ensure appropriateness of services.

    Original languageEnglish (US)
    Pages (from-to)677-685
    Number of pages9
    JournalEarly Intervention in Psychiatry
    Volume12
    Issue number4
    DOIs
    StatePublished - Aug 1 2018

    Fingerprint

    Mental Health Services
    Psychotic Disorders
    Odds Ratio
    Psychiatry
    Hospitalization
    Logistic Models
    Depression
    Adolescent Psychiatry
    Hospital Records
    Therapeutics
    Research
    Mental Disorders
    Caregivers
    Inpatients
    Early Diagnosis
    Schizophrenia
    Parents
    History

    Keywords

    • adolescents
    • first-episode psychosis
    • schizophrenia
    • service utilization
    • treatment adherence

    ASJC Scopus subject areas

    • Phychiatric Mental Health
    • Psychiatry and Mental health
    • Biological Psychiatry

    Cite this

    Gearing, R. E., Brewer, K. B., Mian, I., Moore, K. L., Fisher, P., Hamilton, J., & Mandiberg, J. (2018). First-episode psychosis: Ongoing mental health service utilization during the stable period for adolescents. Early Intervention in Psychiatry, 12(4), 677-685. https://doi.org/10.1111/eip.12366

    First-episode psychosis : Ongoing mental health service utilization during the stable period for adolescents. / Gearing, Robin E.; Brewer, Kathryne B.; Mian, Irfan; Moore, Kiara L.; Fisher, Prudence; Hamilton, Jane; Mandiberg, James.

    In: Early Intervention in Psychiatry, Vol. 12, No. 4, 01.08.2018, p. 677-685.

    Research output: Contribution to journalArticle

    Gearing, RE, Brewer, KB, Mian, I, Moore, KL, Fisher, P, Hamilton, J & Mandiberg, J 2018, 'First-episode psychosis: Ongoing mental health service utilization during the stable period for adolescents', Early Intervention in Psychiatry, vol. 12, no. 4, pp. 677-685. https://doi.org/10.1111/eip.12366
    Gearing, Robin E. ; Brewer, Kathryne B. ; Mian, Irfan ; Moore, Kiara L. ; Fisher, Prudence ; Hamilton, Jane ; Mandiberg, James. / First-episode psychosis : Ongoing mental health service utilization during the stable period for adolescents. In: Early Intervention in Psychiatry. 2018 ; Vol. 12, No. 4. pp. 677-685.
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