Ongoing Mental Health Service Utilization during the Stable Period for Adolescents following First-Episode Psychosis
Robin Gearing1, Jim Mandiberg2, Jane Hamilton3, Kathryne Brewer4, Irfan Mian5, Kiara Moore6, Prudence Fisher6; 1University of Houston, 2Hunter College, 3UT Health, 4University of New Hampshire, 5The Hospital For Sick Children, 6Columbia University
Purpose: The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode of psychosis, but has received less research attention. In this study, variables that could impact continued psychiatric service utilization by adolescents following their first-episode of psychosis and temporal patterns in service utilization are examined. Materials and Methods: Families of 52 adolescents (14.4±2.5 years) discharged following a hospitalization for first-episode psychosis were contacted two or more years following the adolescents’ discharge. A chart review (Time 1) of hospital records provided clinical data on each adolescent’s psychiatric diagnosis, symptoms, illness course, medications, and family history. Follow-up (Time 2) data were collected from parents/caregivers using a questionnaire inquiring about post-discharge treatment history and service utilization. Results: Bivariate analyses were conducted to identify Time 1 variables associated with psychiatric service utilization at Time 2. Significant variables were included in a logistic regression model and three variables were independently associated with continued service utilization: having a primary diagnosis of schizophrenia (OR=24.0; p=.02), not having a first-degree relative with depression (OR=0.12; p=.05), and fewer months since last inpatient discharge (OR=0.92; p=.02). Conclusion: Findings suggest the importance of early diagnosis, that a relative with depression may negatively influence the adolescent’s ongoing service utilization, and that 18-months post-discharge may a critical time to review treatment strategies and collaborate with youth and families to ensure appropriateness of services.
Topic Area: First Episode Psychosis