Patterns and predictors of hospitalisation in first-episode psychosis. Prospective cohort study.
BACKGROUND
Little is known about predictors of hospitalisation in patients with first-episode psychosis.


OBJECTIVE
To identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.


METHODS
Three-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.


RESULTS
Eighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.


CONCLUSIONS
Community-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.
Sipos
A
A
Division of Psychiatry, University of Bristol, Bristol. Attila.Sipos@bristol.ac.uk
Harrison
G
G
Gunnell
D
D
Amin
S
S
Singh
S P
SP
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy; D004739:England; D017050:Episode of Care; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors