A Multisite Canadian Study of Outcome of First-Episode Psychosis Treated in Publicly Funded Early Intervention Services

Abstract

Objective: The aim of this study was to determine 1-year symptomatic outcome and its predictors in patients with first-episode psychosis (FEP) treated at 3 different publicly funded sites. Method: We evaluated FEP patients ( n = 172) treated in specialized programs in 2 medium-sized centres and 1 large urban centre with an identical protocol for demographic variables, diagnosis, and duration of untreated psychosis (DUP) at entry, and positive, negative, and general psychopathology symptoms at entry, 6 months, and 1 year. We used a mixed model analysis of variance, with time and centre and interaction between time and centre as fixed effects and sex and DUP as covariates, to analyze data. Results: A significant effect of time and time x centre interaction on positive, negative, and general symptom outcome was shown after controlling for ethnicity, education, and diagnosis. Patients showed significantly better outcome on all dimensions of symptoms in the 2 medium-sized centres, compared with the 1 large urban centre. Sex had a significant effect on negative and general symptoms, while DUP had no effect on any outcome measure. Conclusions: Similarly enriched early intervention services may produce different outcomes, even within a relatively homogeneous mental health system.