title: Services for people at high risk improve outcomes in patients with first episode psychosis.
abstract: OBJECTIVE
  About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services.
  
  
  METHODS
  Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders.
  
  
  RESULTS
  FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: -33.7 to (-0.3)], had a shorter referral-to-diagnosis time [B coefficient -74.5 days, 95% CI: -101.9 to -(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39-0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34-0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services.
  
  
  CONCLUSIONS
  Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.
authors.affiliation: King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.|South London and Maudsley NHS Foundation Trust, OASIS, London, UK.|Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fusar-Poli
authors.affiliation: King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.|School of Medicine, Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain.
authors.forename: C M
authors.initials: CM
authors.lastname: Díaz-Caneja
authors.affiliation: King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.affiliation: South London and Maudsley NHS Foundation Trust, OASIS, London, UK.|King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Valmaggia
authors.affiliation: King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.|South London and Maudsley NHS Foundation Trust, OASIS, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Byrne
authors.affiliation: King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Garety
authors.affiliation: South London and Maudsley NHS Foundation Trust, Biomedical Research Centre Nucleus, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Shetty
authors.affiliation: South London and Maudsley NHS Foundation Trust, Biomedical Research Centre Nucleus, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Broadbent
authors.affiliation: King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Stewart
authors.affiliation: King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.|South London and Maudsley NHS Foundation Trust, OASIS, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: McGuire
mesh_terms: D000293:Adolescent; D000328:Adult; D042241:Early Diagnosis; D017050:Episode of Care; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services; D063868:Patient Outcome Assessment; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D012189:Retrospective Studies
keywords: ARMS; CRIS; SLaM; UHR; first episode psychosis; prodromal; psychosis risk; schizophrenia