A multisite Canadian study of outcome of first-episode psychosis treated in publicly funded early intervention services.
OBJECTIVE
The aim of this study was to determine 1-year symptomatic outcome and its predictors in patients with FEP treated at 3 different publicly funded sites.


METHODS
We evaluated FEP patients (n = 172) treated in specialized programs in 2 medium-sized centres and 1 large urban centre with an identical protocol for demographic variables, diagnosis, and duration of untreated psychosis (DUP) at entry, and positive, negative, and general psychopathology symptoms at entry, 6 months, and 1 year. We used a mixed model analysis of variance, with time and centre and interaction between time and centre as fixed effects and sex and DUP as covariates, to analyze data.


RESULTS
A significant effect of time and time x centre interaction on positive, negative, and general symptom outcome was shown after controlling for ethnicity, education, and diagnosis. Patients showed significantly better outcome on all dimensions of symptoms in the 2 medium-sized centres, compared with the 1 large urban centre. Sex had a significant effect on negative and general symptoms, while DUP had no effect on any outcome measure.


CONCLUSIONS
Similarly enriched EI services may produce different outcomes, even within a relatively homogeneous mental health system.
Malla
Ashok
A
Department of Psychiatry, McGill University, Douglas Hospital Research Centre, Montreal, Quebec. ashok.malla@douglas.mcgill.ca
Schmitz
Norbert
N
Norman
Ross
R
Archie
Suzanne
S
Windell
Deborah
D
Roy
Paul
P
Zipursky
Robert B
RB
D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018479:Early Intervention, Educational / Q000191:economics; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D017150:Public Sector; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome