Enhancing Timely and Accurate Identification of First Episode Psychosis through Systematic Diagnostic Training

Poster A59, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Hong Ngo1,2, Iruma Bello1,2, Ilana Nossel1,2, Lisa Dixon1,2; 1Columbia University Irving Medical Center, 2New York State Psychiatric Institute

Purpose: Timely identification and treatment improve outcomes for individuals experiencing first episode psychosis (FEP). Coordinated Specialty Care (CSC) has been demonstrated to be most effective for individuals with primary non-affective psychotic disorders (PNPD). Studies also found diagnostic challenges in identifying PNPD, especially among adolescents, resulting in misdiagnosis and enrollment of non-eligible individuals to CSC programs. Given limited availability and higher costs of CSC compared to typical care, trainings that enhance accurate diagnosis of FEP are paramount. While use of structured interviews (e.g., Structured Clinical Interview for DSM-5) may be optimal, the necessary training may be impractical across large care systems. We describe our systematic approach to addressing diagnostic and eligibility challenges across OnTrackNY teams (New York State’s CSC program) and outcomes. Methods: Our systematic process for diagnostic training included: (1) review of eligibility evaluation documentation (EED) of 93 actively enrolled participants across eight teams to identify areas of diagnostic challenges and (2) development and delivery of a six-module diagnostic training based on identified challenges to all teams. Results: Pilot review of EED found 19.4% (N=18) of 93 enrolled participants were non-eligible. Common reasons for non-eligibility were: substance-induced psychosis, primary mood disorder, personality disorder, PTSD, and subthreshold symptoms. After a six-module training, review of EED among the same eight teams for participants enrolled within the past month (N=24) found 100% of these participants eligible. Conclusion: Though our study cannot determine validity of diagnoses, understanding assessment challenges combined with targeted training may be useful to improve the evaluation process of FEP teams.

Topic Area: First Episode Psychosis

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