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Use of early psychosis intervention services reduces mortality rates

15 May 2018

Mortality rates are four times lower among individuals with first-episode psychosis who used early psychosis intervention (EPI) services than those with first-episode psychosis who did not use these services, reports a new study. Use of EPI services also leads to better outcomes across several healthcare system indicators.

Over the 2-year period after admission to the EPI programme, individuals who used EPI services had substantially lower rates of all-cause mortality (hazard ratio [HR], 0.24; 95 percent CI, 0.11–0.53). However, there was no significant between-group difference in self-harm (HR, 0.86; 0.18–4.24) and suicide (HR, 0.73; 0.29–1.80).

In addition, use of EPI services resulted in lower rates of emergency department presentation (HR, 0.71; 0.60–0.83) but higher rates of hospitalization (HR, 1.42; 1.18–1.71). When EPI care was stepped down to medical management after 2 years, these benefits were not observed.

“These findings support the effectiveness of EPI services for the treatment of first-episode psychosis in the larger context of the overall healthcare system,” the authors said.

In this study, health administrative data was used to construct a retrospective cohort of incident cases of nonaffective psychosis in the catchment area of the Prevention and Early Intervention Program for Psychoses in London, Ontario, between 1997 and 2013.

The authors linked this cohort to primary data from the same programme to identify those who used EPI services. Cox proportional hazards models were used to compare outcomes for individuals who used EPI services and those who did not.

“EPI programmes improve clinical and functional outcomes for people with first-episode psychosis, [but] less is known about the impact of these programmes on the larger healthcare system,” the authors said.

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