Patterns and predictors of hospitalisation in first-episode psychosis - Prospective cohort study

Background Little is known about predictors of hospitalisation in patients with first-episode psychosis. Aims To identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist s ervices. Method Three-year follow-up of a cohort of 166 patients with a first episod e of psychosis making contact with psychiatric services in Nottingham betwe en June 1992 and May 1994. Results Eighty-eight (53.0%) patients were admitted within 1 week of presen tation; 32 (19.3%) were never admitted during the 3 years of follow-up. Man ic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms an d a longer duration of untreated illness had an increased risk of late admi ssion. Conclusions Community-oriented psychiatric services might only delay, rathe r than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upo n first admissions are likely to be subject to selection biases, which may limit their representativeness. Declaration of interest Funded by NHS Executive Trent Research and Developm ent.