Original Research Status of First-Episode Psychosis Patients Presenting for Routine Care in a Defined Catchment Area

atients suffering from schizophrenia make many demands on the health care system over the course of their illness. Treatment of the first episode or early phase of schizophrenia is regarded as a crucial time for intervention (1). The literature supports the notion of a plateau effect (2), whereby any deteri-oration occurs aggressively in the first 2 to 3 years and critical psychosocial influences, including family’s response and psychological reactions to psychosis and psychiatric services, develop during this period. Admission to hospital is the first psychiatric contact for most patients ’ FEP (3–4). Many of these patients obtain admission Can J Psychiatry, Vol 51, No 1, January 200642 Objective: To examine the clinical and behavioural status of all first-episode psychosis (FEP) patients admitted to hospital within a defined catchment area. Method: We used a structured format to review clinical records of all first admissions to hospitals from a catchment area (population 390 000) with diagnosis of a first episode of nonaffective psychosis over a 3-year period. Results: Patients were somewhat older than usually reported for FEP (mean age 31.3 years). They were mostly male (63.7%), single (80.8%), unemployed (87.4%), with a primary diagnosis of schizophrenia spectrum psychoses (85%), and had spent a mean of 31 days in an open inpatient unit and 2.93 days in an intensive care psychiatric unit during their first admission. Most (60.3%) were admitted involuntarily; 34.2 % had a history of legal involvement; 18.8 % had attempted suicide prior to admission; 31.5 % had demonstrated violence toward people, property, or animals; 14.4 % had suffered injuries; and 15.9 % had shown aggressive behaviour during the hospital admission. Conclusions: These results identify some of the potential needs of FEP patients, toward whom early intervention services should be directed. (Can J Psychiatry 2005;50:42–47) Information on funding and support and author affiliations appears at the end of the article