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The over-35s: early intervention in psychosis services entering uncharted territory

  • Felix Clay (a1), Sophie Allan (a1), Serena Lai (a1), Siona Laverty (a1), Grace Jagger (a1), Cate Treise (a1) and Jesus Perez (a1) (a2) (a3)...
Abstract
Aims and method

Following the introduction of new standards for early intervention in psychosis (EIP) in England, EIP services are accepting referrals for people aged 35–65. The Cambridgeshire and Peterborough EIP service (CAMEO) aimed to explore the immediate implications for the service, especially with regards to referral numbers and sources. Data were collected from April 2016 to June 2017.

Results

Referrals for over-35s represented 25.7% of all new referrals. Fifty per cent of referrals for over-35s were accepted onto caseload (40.2% for under-35s). The over-35s were more likely to be referred from acute and secondary mental health services (P < 0.01) and had longer durations of untreated psychosis than the under-35s (P = 0.02).

Clinical implications

CAMEO has received a significantly higher number of referrals as a result of age inclusivity, with an increased proportion of patients suffering from severe, acute psychotic presentations and existing mental health difficulties. This has implications for service planning.

Declaration of interest

None.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Jesus Perez (jp440@cam.ac.uk)
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These authors contributed equally to this work.

Footnotes
References
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1NHS England. Guidance for Reporting Against Access and Waiting Time Standards: Early Intervention in Psychosis. NHS England, 2016 (https://www.england.nhs.uk/mental-health/resources/access-waiting-time/).
2National Institute for Health and Care Excellence. Psychosis and Schizophrenia in Adults: Quality Standard 80. NICE, 2015 (https://www.nice.org.uk/guidance/qs80/chapter/quality-statement-1-referral-to-early-intervention-in-psychosis-services).
3Greenfield, P, Joshi, S, Christian, S, Lekkos, P, Gregorowicz, A, Fisher, HL, et al. First episode psychosis in the over 35s: is there a role for early intervention? Early Interv Psychiatry 2016; doi: 10.1111/eip.12322.
4Lappin, J, Heslin, M, Jones, P, Doody, G, Reininghaus, U, Demjaha, A, et al. Outcomes following first-episode psychosis – Why we should intervene early in all ages, not only in youth. Aust N Z J Psychiatry 2016; 50(11): 1055–63.
5Lasalvia, A, Bonetto, C, Lenzi, J, Rucci, P, Iozzino, L, Cellini, M, et al. Predictors and moderators of treatment outcome in patients receiving multi-element psychosocial intervention for early psychosis: results from the GET UP pragmatic cluster randomised controlled trial. Br J Psychiatry 2017; 210(5): 342–9.
6Cambridgeshire & Peterborough Clinical Commissioning Group Commissioning Strategy for Adult Mental Health and Well-Being 2013–2016. CAPCCG, 2013 (http://www.cpft.nhs.uk/Downloads/rod%20files/2013_08-16_CCG_Adult_MH_Commissioning_Strategy_2013_FINAL.pdf).
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The over-35s: early intervention in psychosis services entering uncharted territory

  • Felix Clay (a1), Sophie Allan (a1), Serena Lai (a1), Siona Laverty (a1), Grace Jagger (a1), Cate Treise (a1) and Jesus Perez (a1) (a2) (a3)...
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