Friday, April 7, 2017

High Mortality Rate Found in Youth Newly Diagnosed With Psychosis

Young patients who have been diagnosed with first-episode psychosis (FEP) are much more likely to die within a year of diagnosis than their age-matched peers—in fact, at least 24 times greater, according to a study published April 6 online by Schizophrenia Bulletin.

The findings suggest that youth experiencing psychosis should receive immediate and effective clinical attention, which is often lacking in their follow-up.

Michael Schoenbaum, Ph.D., senior advisor for mental health services, epidemiology, and economics at the National Institute of Mental Health, and his team used health insurance claims data and information from the Social Security Administration to assess the 12-month health outcomes in a group of 5,488 insured young adults aged 16 to 30 years who received a diagnosis of FEP. The researchers examined patterns of outpatient and inpatient treatment, emergency department visits, and all-cause deaths in the study group.

Using the most conservative assumptions, the researchers calculated an all-cause death rate of 1,968 per 100,000 of the cohort, a rate seen only in people aged 70 and over in the general population. In addition, 62% of the cohort had at least one hospitalization and/or one emergency department visit during the initial year of care; 61% did not fill any antipsychotic prescriptions; and 41% did not receive psychotherapy.

“Given accumulating evidence associating timely FEP treatment with positive clinical, social, and employment outcomes, the present findings reinforce the need for widely available coordinated specialty care programs and strategies to provide them as early in after psychosis onset as possible,” Schoenbaum and colleagues wrote. “Such programs are needed to improve outcomes for people experiencing FEP and might help mitigate the extraordinarily high rates of mortality observed in this vulnerable population.”

For related information, see the Psychiatric News article “Early Intervention Trial in Youth at Risk for Psychosis Shows Improved Symptoms” and the Psychiatric Services article “Systematic Review of Integrated General Medical and Psychiatric Self-Management Interventions for Adults With Serious Mental Illness.”

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