title: Predictors of functional status at service entry and discharge among young people with first episode psychosis.
abstract: Most patients with first episode psychosis (FEP) are neither studying nor employed (have a poor functional status) when first accessing care. Knowledge of the characteristics of patients with poor functioning and the features influencing functional status over time may pave the way to better treatment.
  
  
  
  A medical file audit was used to collect data on premorbid, entry, treatment and 18-month outcome characteristics on 661 FEP patients who consecutively attended the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, between 1998 and 2000. Functional status was ascertained using the modified vocational status index and was rated at baseline (poor or good) and according to its evolution over the treatment period (stable good, stable poor, deteriorating or improved functional status).
  
  
  
  52.0% of patients had a poor functional status at service entry. They were more likely to be male with a non-affective psychosis. They also had lower levels of premorbid global functioning and education, and were more likely to have self-reported histories of learning disability, forensic issues, traumatic experiences and substance use. At service entry, they had more severe symptoms and poorer global functioning. 37% of these patients maintained a poor functional status at discharge, and 18% of those with a good functional status at service entry experienced a decline.
  
  
  
  Although psychosocial interventions might assist a young person with FEP with working towards functional goals, for some, the impact of factors such as ongoing substance use and forensic issues on functional status needs to be addressed.
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia. smcotton@unimelb.edu.au.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. smcotton@unimelb.edu.au.
authors.forename: S M
authors.initials: SM
authors.lastname: Cotton
authors.affiliation: Department of Psychiatry and Psychotherapy, Psychosis Centre, Centre of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lambert
authors.affiliation: University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland.
authors.forename: B G
authors.initials: BG
authors.lastname: Schimmelmann
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Filia
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Rayner
authors.affiliation: School of Psychology, University of Queensland, Brisbane, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Hides
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: D L
authors.initials: DL
authors.lastname: Foley
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Ratheesh
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Watson
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Rodger
authors.affiliation: Orygen, The National Centre of Excellence in Youth Health, Locked Bag 10 (35 Poplar Road), Parkville, VIC, 3052, Australia.|Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: P D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Clinique de Cery, Université de Lausanne, 1008, Prilly, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Conus
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010351:Patient Discharge; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D016896:Treatment Outcome; D014938:Work Capacity Evaluation
keywords: Education; Employment; First episode psychosis; Functioning; Outcome