What needs to follow early intervention? Predictors of relapse and functional recovery following first-episode psychosis
Article first published online: 20 NOV 2013
© 2013 Wiley Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 9, Issue 4, pages 279–283, August 2015
How to Cite
Kam, S. M., Singh, S. P. and Upthegrove, R. (2015), What needs to follow early intervention? Predictors of relapse and functional recovery following first-episode psychosis. Early Intervention in Psychiatry, 9: 279–283. doi: 10.1111/eip.12099
- Issue published online: 14 JUL 2015
- Article first published online: 20 NOV 2013
- Manuscript Accepted: 22 SEP 2013
- Manuscript Received: 22 APR 2013
- early intervention;
- social function
As a foundation for considering how gains may be maintained following early intervention in first-episode psychosis (FEP), this study aimed to describe and investigate factors predicting post-discharge relapse and longer term functioning.
An evaluation via case-note review obtained quantitative data on 163 patients sequentially discharged from Birmingham Early Intervention Service (EIS) followed up for a median of 3.6 years. Time to relapse was calculated and hierarchical regression was used to determine predictors of relapse and functioning.
Patients likely to relapse do so within the first year post-discharge; however, over 40% did not relapse during the follow-up period. The number of relapses occurring during EIS care predicted time-to-relapse post-discharge. At discharge from the EIS and study end-point, the proportion with low social and vocational functioning remained high. Predictors of positive ‘Not in Education Employment or Training’ status at end-point include being in a minority ethnic group, substance misuse and number of relapses.
Increased emphasis on relapse prevention and early post-discharge monitoring may be needed, especially in the first year, for those who have experienced previous relapse. To maintain early outcomes in FEP, targeted interventions to address substance misuse and functional recovery need to be sustained in the long term. EISs should aim to make the first episode of psychosis the last. Services providing care for patients with psychosis post EIS should be designed to deliver care for ongoing need, with continued emphasis on relapse prevention and social recovery.