title: Patients With First-Episode Psychosis are Not a Homogeneous Population: Implications for Treatment.
abstract: OBJECTIVE
  This study aimed at defining the characteristics of a population of patients diagnosed with first-episode psychosis (FEP), and accessing for the first time a center for early intervention in psychosis in the health district of Milan and its surroundings.
  
  
  METHODS
  Patients were included in the study from January 2007 to December 2008; criteria: first contact with any public mental health service of the catchment area for a first episode of schizophrenia or related syndromes according to the ICD-10 criteria. Cluster analysis was used to divide patients into groups based on the main socio-demographic and clinical characteristics at presentation.
  
  
  RESULTS
  Overall, 91 FEP patients were enrolled in the study. Two clusters were identified, which differed principally by symptom profile. Patients in cluster 1 (n=36) had severe agitation, and a history of alcohol and/or substance abuse at presentation more often than those in cluster 2 (n=55), who were more likely to suffer at presentation from severe depression or apathy, anxiety, poor self-care, functional or work impairment and severe social withdrawal. After six months of treatment patients improved on almost all symptomatic dimensions on the Health of the Nation Outcome Scale and the Brief Psychiatric Rating Scale, with greater improvement in cluster 1 than in cluster 2.
  
  
  CONCLUSIONS
  The findings of this study need replication in larger samples and on a wider severity scale. Nevertheless, the heterogeneity of patients with FEP might impact on treatment. Policymakers should recognize the importance of the diagnostic and outcome assessment in the treatment of severe mental disorders.
authors.affiliation: Dipartimento di Salute Mentale: Programma2000, Azienda Ospedaliera Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Cocchi
authors.affiliation: Dipartimento di Salute Mentale, Azienda Ospedaliera Ospedale Civile di Legnano, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cerati
authors.affiliation: Dipartimento Salute Mentale, Azienda Ospedaliera della Provincia di Lecco, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lora
authors.affiliation: Dipartimento di Salute Mentale: Programma2000, Azienda Ospedaliera Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Meneghelli
authors.affiliation: Dipartimento di Salute Mentale: Programma2000, Azienda Ospedaliera Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Monzani
authors.affiliation: Dipartimento di Salute Mentale - A.O. "G. Salvini", Garbagnate Milanese, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Percudani
authors.affiliation: Comitato Tecnico per le Innovazioni in Salute Mentale. Direzione Generale Sanità - Regione Lombardia, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Petrovich
authors.affiliation: Reparto Salute Mentale, Centro Nazionale di Epidemiologia Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Fiorino
authors.initials: F
authors.lastname: Mirabella
authors.affiliation: Reparto Salute Mentale, Centro Nazionale di Epidemiologia Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.affiliation: Dipartimento di Salute Mentale: Programma2000, Azienda Ospedaliera Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Preti
keywords: First episode psychosis; duration of untreated psychosis.; early intervention; schizophrenia