title: Three-year outcome of first-episode psychoses in an established community psychiatric service.
abstract: BACKGROUND
  Changes in service provision, secular trends in substance misuse and changing social structures might affect outcome in psychosis.
  
  
  OBJECTIVE
  To assess the three-year outcome of an inception cohort of first-episode psychoses treated in a modern, community-oriented service; to compare outcomes with an earlier cohort treated in hospital-based care; and to examine the predictive validity of ICD-10 diagnostic criteria.
  
  
  METHODS
  Three-year follow-up (1995-1997) of an inception cohort of first-episode psychoses and comparison with two-year follow-up (1980-1982) of the Determinants of Outcome of Severe Mental Disorders (DOSMED) Nottingham cohort.
  
  
  RESULTS
  On most outcome measures, non-affective psychoses had a worse outcome than affective psychoses. Affective psychoses had better outcome than previously reported. Substance-related psychoses had very poor occupational outcome. Similar proportions of the current and DOSMED cohort were in remission but the former were rated as having greater disability.
  
  
  CONCLUSIONS
  In a modern community service, 30-60% of patients with first-episode psychoses experience a good three-year outcome. The ICD-10 criteria have good predictive validity.
authors.affiliation: Division of Psychiatry, University of Nottingham.
authors.forename: S P
authors.initials: SP
authors.lastname: Singh
authors.forename: T
authors.initials: T
authors.lastname: Croudace
authors.forename: S
authors.initials: S
authors.lastname: Amin
authors.forename: R
authors.initials: R
authors.lastname: Kwiecinski
authors.forename: I
authors.initials: I
authors.lastname: Medley
authors.forename: P B
authors.initials: PB
authors.lastname: Jones
authors.forename: G
authors.initials: G
authors.lastname: Harrison
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000458:organization & administration*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000145:classification / Q000175:diagnosis / Q000534:rehabilitation*