Skip to main content Accessibility help
×
Home
Hostname: page-component-564cf476b6-pp5r9 Total loading time: 0.282 Render date: 2021-06-18T11:22:22.445Z Has data issue: false Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Hospitalisation in First-episode psychosis

Published online by Cambridge University Press:  02 January 2018

P. Arshad
Affiliation:
Salford Primary Care NHS Trust, Salford, UK
M. Marcos
Affiliation:
Meadowbrook, Department of Psychological Medicine, Stott Lane, Salford M6 8HG, UK
B. Sridharan
Affiliation:
Salford Primary Care NHS Trust, Salford, UK
Rights & Permissions[Opens in a new window]

Abstract

Type
Columns
Copyright
Copyright © 2002 The Royal College of Psychiatrists 

The paper by Sipos et al (Reference Sipos, Harrison and Gunnell2001) was discussed with great enthusiasm in our evidence-based journal club. We learnt that 80% of patients with first-episode psychosis were hospitalised within 3 years of first contact with specialist services. Patients with manic symptoms at presentation were admitted rapidly; those with negative symptoms and longer duration of untreated illness were admitted later. The paper concluded that community-oriented psychiatric services might only delay, rather than prevent, admission of patients with a first-episode of psychosis.

At the end of the journal club we realised that the findings from this paper cannot be generalised to our patient group without the knowledge of certain other key issues not mentioned in the paper.

  1. (a) Availability of in-patient beds: studies have shown that the utilisation of in-patient care is determined by the supply of available beds (Reference Saarento, Hanson and SandlundSaarento et al, 1996).

  2. (b) Availability of assertive community psychiatric services: an assertive community treatment programme has shown to be effective in reducing hospitalisation compared with clinical case management programmes (Reference Ziguras and StuartZiguras & Stuart, 2000).

  3. (c) A study by Lang et al (Reference Lang, Davidson and Bailey1999) demonstrates that improvement in social support predicted decline in hospitalisation.

  4. (d) History of suicidal behaviour carries a greater risk of admission in first-episode psychosis and higher readmission rates over 2-year follow-up (Reference Verdoux, Liraud and GonzalesVerdoux et al, 2001).

  5. (e) In clinical practice a patient's willingness to accept treatment as an out-patient would be a factor in deciding about in-patient treatment.

In our opinion hospitalisation in first-episode psychosis would be greatly affected by the above issues and without knowledge of these issues, the findings from Sipos et al's study cannot be generalised to patient groups in other areas/services.

Footnotes

EDITED BY MATTHEW HOTOPF

References

Lang, M. A. Davidson, L. Bailey, P. et al (1999) Clinicians' and clients' perspectives on the impact of assertive community treatment. Psychiatric Services, 50, 13311340.CrossRefGoogle ScholarPubMed
Saarento, O. Hanson, L. Sandlund, M. et al (1996) The Nordic Comparative Study on Sectorized Psychiatry. Utilisation of psychiatric hospital care related to amount and allocation of resources to psychiatric services. Social Psychiatry and Psychiatric Epidemiology, 31, 327335.CrossRefGoogle Scholar
Sipos, A. Harrison, G. Gunnell, D. et al (2001) Patterns and predictors of hospitalisation in first-episode psychosis: prospective cohort study. British Journal of Psychiatry, 178, 518523.CrossRefGoogle ScholarPubMed
Verdoux, H. Liraud, F. Gonzales, B. et al (2001) Predictors and outcome characteristics associated with suicidal behaviour in early psychosis: a two-year follow-up of first-admitted subjects. Acta Psychiatrica Scandinavica, 103, 347354.CrossRefGoogle ScholarPubMed
Ziguras, S. J. & Stuart, G. W. (2000) Ameta analysis of the effectiveness of mental health case-management over 20 years. Psychiatric Services, 51, 14101421.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.
You have Access
1
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Hospitalisation in First-episode psychosis
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Hospitalisation in First-episode psychosis
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Hospitalisation in First-episode psychosis
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *