title: Impact of early intervention services on duration of untreated psychosis: data from the National EDEN prospective cohort study.
abstract: OBJECTIVE
  This study aimed to determine if the inception of Early Intervention Services (EISs) is followed by an improvement in the prompt treatment of people with first episode psychosis.
  
  
  METHODS
  A prospective cohort study of referrals to new and established EISs was conducted at 1, 2, 3, and 4 years after inception of new EIS. The study was conducted with 14 (seven new and seven established) secondary care EIS within geographically defined catchment areas in England between 2005 and 2009. Participants included 1027 consecutive referrals to EIS aged 14-35 with a first episode of psychosis. Duration of untreated psychosis (DUP) and number of participants treated adequately within 6 months of onset were the main outcome measures.
  
  
  RESULTS
  A significant downward trend across yearly cohorts for DUP for new EIS (F1,549=8.4, p=0.004) but not for established EIS (F1,429=1.7, p=0.19) was observed. There was a significant upward trend across cohorts in the proportion of referrals treated within 6 months for new EIS (X(2)=8.0, df=1, p=0.005), but not for established EIS (X(2)=0.1, df=1, p=0.72).
  
  
  CONCLUSIONS
  The introduction of new EIS was followed by a reduction in DUP and an increase in the proportion of patients treated within 6 months of onset. These trends were not present in the catchment areas of established services where DUP was initially lower, suggesting that there was no general tendency for DUP to fall over time. Hence, the introduction of an EIS was followed by an improvement in the prompt and proper treatment of first episode psychosis.
authors.affiliation: School of Medicine, University of Manchester, United Kingdom. Electronic address: max.marshall@manchester.ac.uk.
authors.forename: Max
authors.initials: M
authors.lastname: Marshall
authors.affiliation: School of Medicine, University of Manchester, United Kingdom.
authors.forename: Nusrat
authors.initials: N
authors.lastname: Husain
authors.affiliation: School of Medicine, University of Manchester, United Kingdom.
authors.forename: Natalie
authors.initials: N
authors.lastname: Bork
authors.affiliation: School of Medicine, University of Manchester, United Kingdom.
authors.forename: Imran B
authors.initials: IB
authors.lastname: Chaudhry
authors.affiliation: University of Birmingham, Birmingham, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Lester
authors.affiliation: University of Birmingham, Birmingham, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Everard
authors.affiliation: Health Sciences Research Institute, University of Warwick, Warwick, United Kingdom.
authors.forename: Swaran P
authors.initials: SP
authors.lastname: Singh
authors.affiliation: Department of Primary Care and Population Health, University College, London, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
authors.affiliation: University of Cheshire, United Kingdom.
authors.forename: Vimal
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: School of Medicine, University of East Anglia, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.affiliation: Academic Unit of Psychiatry, University of Bristol, Bristol, United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
authors.affiliation: School of Medicine, University of Manchester, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomenson
authors.affiliation: University of Birmingham, Birmingham, United Kingdom.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
mesh_terms: D000293:Adolescent; D000328:Adult; D061345:Early Medical Intervention / Q000379:methods*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000453:epidemiology / Q000628:therapy*; D012680:Sensitivity and Specificity; D061665:Time-to-Treatment; D055815:Young Adult
keywords: Duration of untreated psychosis; Early Intervention Service; Psychosis