First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Abstract

Aim To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world.

Public health primary prevention implemented by clinical high-risk services for psychosis

“…[ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ] Academic/occupational performance • Onsite vocational reintegration, including supported employment or IPS. [ 34 , 35 , 54 , 55 , 73 , 76 , 80 ] Academic/occupational performance • Intensive networking with local/community stakeholders. [ 19 , 28 , 34 , 38 , 41 , 74 , 77 ] Academic/occupational performance • Psychosocial support with housing and accommodation.…”

“…[ 19 , 20 , 22 , 27 , 29 , 30 , 32 , 36 – 38 , 40 , 43 , 44 , 53 , 56 , 57 , 63 , 66 , 77 – 79 ] Mental health literacy, attitude towards mental disorders • Training and mental health awareness for professionals working with young people. [ 19 , 20 , 22 , 24 , 27 , 29 , 32 , 35 – 38 , 40 , 44 , 45 , 49 , 50 , 52 , 54 , 56 , 57 , 62 – 64 , 68 – 70 , 72 , 73 , 75 , 77 – 79 ] Mental health literacy, attitude towards mental disorders Selective strategies and corresponding good mental health domains • Problem-solving training. [ 18 , 57 , 58 , 78 , 79 ] Self-management skills • Individual or group psychoeducation.…”

“…[ 74 , 77 ] Self-management skills • Family psychoeducation, counselling or support. [ 11 , 17 , 23 , 26 , 27 , 32 , 35 , 36 , 42 , 43 , 45 , 49 , 51 , 52 , 54 – 65 , 71 – 73 , 76 – 78 , 81 ] Family and significant relationships • Psychosocial support on social relationships and functioning. [ 11 , 27 , 28 , 30 , 36 , 43 , 45 , 49 , 50 , 54 , 55 , 58 , 59 , 77 ] Social skills • Educational support.…”

“…[ 11 , 17 , 23 , 26 , 27 , 32 , 35 , 36 , 42 , 43 , 45 , 49 , 51 , 52 , 54 – 65 , 71 – 73 , 76 – 78 , 81 ] Family and significant relationships • Psychosocial support on social relationships and functioning. [ 11 , 27 , 28 , 30 , 36 , 43 , 45 , 49 , 50 , 54 , 55 , 58 , 59 , 77 ] Social skills • Educational support. [ 11 , 27 , 28 , 35 , 36 , 49 , 52 , 57 , 58 , 74 , 76 , 77 ] Academic/occupational performance • Cognitive Remediation Training [ 72 ] Cognitive skills • Physical health assessment and monitoring.…”

“…computer training), support job seeking and retention [ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ]. In addition, CHR-P services provided specific programmes for onsite vocational reintegration, such as supported employment or individual placement and support (IPS) [ 34 , 35 , 54 , 55 , 73 , 76 , 80 ], often through intense networking with local/community stakeholders [ 19 , 28 , 34 , 38 , 41 , 74 , 77 ].…”