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Beyond the crisis: Ongoing psychiatric treatment and service utilization after initial symptom stabilization following first-episode psychosis for adolescents

Published online by Cambridge University Press:  23 March 2020

R. Gearing ,
K. Brewer ,
I. Mian ,
K. Moore ,
P. Fisher ,
J. Hamilton  and
J. Mandiberg
R. Gearing
Affiliation:
University of Houston, GCSW, Houston, USA
K. Brewer
Affiliation:
University of New Hampshire, college of health and human services, Durham, USA
I. Mian
Affiliation:
The hospital for sick children, department of psychiatry, Toronto, Canada
K. Moore
Affiliation:
Columbia university, CSSW, New York, USA
P. Fisher
Affiliation:
New York state psychiatric institute/Columbia college of physicians & surgeons, division of child and adolescent psychiatry, New York, USA
J. Hamilton
Affiliation:
UT health McGovern medical school, department of psychiatry and behavioral sciences, Houston, USA
J. Mandiberg
Affiliation:
Hunter university, CUNY, New York, USA

Abstract

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Introduction

The importance of timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. However, ongoing psychiatric treatment and service utilization after the symptoms have been stabilized over the initial years following first-episode has received less research attention.

Objectives

To model the variables predicting continued service utilization with psychiatrists for adolescents following their first-episode psychosis; examine associated temporal patterns in continued psychiatric service utilization.

Methods

This study utilized a cohort design to assess adolescents (age 14.4 ± 2.5 years) discharged following their index hospitalization for first-episode psychosis. Bivariate analyses were conducted on predictor variables associated with psychiatric service utilization. All significant predictor variables were included in a logistic regression model.

Results

Variables that were significantly associated with psychiatric service utilization included: diagnosis with a schizophrenia spectrum disorder rather than major mood disorder with psychotic features (OR = 24.0; P = 0.02), a first degree relative with depression (OR = 0.12; P = 0.05), and months since last psychiatric inpatient discharge (OR = 0.92; P = 0.02). Further examination of time since last hospitalization found that all adolescents continued service utilization up to 18 months post-discharge.

Conclusions

Key findings highlight the importance of early diagnosis, that a first degree relative with depression may negatively influence the adolescent's ongoing service utilization, and that 18 months post-discharge may a critical time to review current treatment strategies and collaborate with youth and families to ensure that services continue to meet their needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Mental health care; Mental health policies and migration and mental health of immigrants
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S337
Copyright
Copyright © European Psychiatric Association 2017
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