Study Examines US Mortality Rates for First-Episode Psychosis

https://goo.gl/EZUHLS

A recent study published in Schizophrenia Bulletin examines patterns of mental health care use in the 12 months after patients in the US receive an initial diagnosis of psychosis. The study estimates that 12-month mortality for individuals who had received psychosis diagnosis was 24 times greater than that of the general population. Moreover, in the year following the initial diagnosis of first-episode psychosis (FEP), 61% of the individuals with psychosis did not fill prescriptions for antipsychotics and 41% did not receive any individual psychotherapy services.

Past research has found that people diagnosed with “schizophrenia” have significantly higher mortality rates than the general population, often due to co-occurring medical issues including cardiovascular disease, diabetes, and suicide. In fact, research conducted in the UK has demonstrated that the mortality gap between the general population and individuals diagnosed with bipolar and schizophrenia is widening. Intervention and treatment efforts have shifted to early intervention programs which have demonstrated improved outcomes including a reduction in suicide risk.

However, the authors of this study point out that the “United States has been slower to focus on early intervention” which has resulted in a lack of knowledge regarding how persons who have experienced a first-episode of psychosis utilize treatment. To fill this gap, the authors of the present study looked at longitudinal patterns of outpatient treatment, inpatient treatment, emergency room visits, and mortality rates in a national cohort of individuals who had experienced a first-episode of psychosis.

Individuals with an inpatient, emergency, or outpatient visit that had received a diagnosis of schizophrenia, brief psychotic disorder, or psychotic disorder not otherwise specified (NOS) between the ages of 16-30 were identified. Information was gathered on mortality within a year of receiving a psychosis diagnosis, use of pharmacotherapy, and health service use including outpatient, inpatient, and emergency care.

A total of 1357 individuals were included. 85% of patients were under 25 years of age when they received the initial psychosis diagnosis and 61% of those included were male.

12-month mortality was 2%, compared to <.1% in the general population. Those who had a later onset (after age 25) of psychosis had higher rates of mortality than those who received the diagnosis between 16 and 20 years of age. Within this cohort, mortality rates for the 16-20 age range were 8 times that of the general population, 21 times the rate of the general population for the 21-25 group, and 54 times the rate in the 26-30 group.


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