Clinical profiles, scope and general findings of the Western Sydney First Episode Psychosis Project.
OBJECTIVE
To examine the clinical profile, treatment and social functioning of a community-based sample of young people presenting with their first episode of psychosis.


METHODS
Over a 2-year period, young people with their first episode of psychosis referred to early intervention services in two area mental health services in western Sydney were assessed with a battery of clinical, neuropsychological, psychophysiological and neuroanatomical measures. This paper reports the clinical results of the baseline section of the study.


RESULTS
Of the 224 referrals to the project, 94 subjects meet inclusion criteria and agreed to take part. Subjects were divided into three diagnostic groups--'Schizophrenia', 'Mood Disorders' and 'Mixed Psychosis', the latter principally comprised of substance induced psychotic disorders. Subjects from the 'Schizophrenia' group differed significantly from the other two groups in that they had higher levels of negative symptoms and general psychopathology, and were less likely to be employed or engaged in study. They had poorer overall social functioning. Subjects with 'Mixed Psychosis' were similar to those from the 'Schizophrenia' group in that they were older and male, but they did not have the same burden of negative symptoms as the 'Schizophrenia' group. The 'Mood Disorders' group was younger, female and had overall a higher level of psychosocial functioning than the other two groups. Subjects from the 'Mood Disorders' group were more likely to be managed with mood stabilisers and multiple drug therapies. The use of atypical antipsychotic medication was almost universal.


CONCLUSIONS
Even shortly after the time of presentation to mental health services young people with a schizophrenia spectrum diagnosis have a heavier burden of symptoms and are significantly more impaired by them than young people with other psychotic illnesses. This and their symptom profile differentiated them from young people with other psychotic disorders.
Harris
Anthony
A
University of Sydney, Westmead Hospital, New South Wales, Australia. aharris1@mail.usyd.edu.au
Brennan
John
J
Anderson
Josephine
J
Taylor
Anne
A
Sanbrook
Mark
M
Fitzgerald
Dianne
D
Lucas
Sara
S
Redoblado-Hodge
Antoinette
A
Gomes
Lavier
L
Gordon
Evian
E
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D009483:Neuropsychological Tests; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012917:Social Adjustment
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents