Predictors of functional status at service entry and discharge among young people with first episode psychosis

Cotton, S. M., Lambert, M., Schimmelmann, B.G., Filia, K., Rayner, V., Hides, L., Foley, D. L., Ratheesh, A., Watson, A., Rodger, P., McGorry, P. D. and Conus, P. (2017) Predictors of functional status at service entry and discharge among young people with first episode psychosis. Social Psychiatry and Psychiatric Epidemiology, 52 5: 575-585. doi:10.1007/s00127-017-1358-0

Author Cotton, S. M.
Lambert, M.
Schimmelmann, B.G.
Filia, K.
Rayner, V.
Hides, L.
Foley, D. L.
Ratheesh, A.
Watson, A.
Rodger, P.
McGorry, P. D.
Conus, P.
Title Predictors of functional status at service entry and discharge among young people with first episode psychosis
Journal name Social Psychiatry and Psychiatric Epidemiology   Check publisher's open access policy
ISSN 0933-7954
Publication date 2017-05-01
Year available 2017
Sub-type Article (original research)
DOI 10.1007/s00127-017-1358-0
Open Access Status Not yet assessed
Volume 52
Issue 5
Start page 575
End page 585
Total pages 11
Place of publication Heidelberg, Germany
Publisher Springer Medizin
Language eng
Subject 2713 Epidemiology
3306 Health (social science)
3207 Social Psychology
2738 Psychiatry and Mental health
Abstract Objective: Most patients with first episode psychosis (FEP) are neither studying nor employed (have a poor functional status) when first accessing care. Knowledge of the characteristics of patients with poor functioning and the features influencing functional status over time may pave the way to better treatment. Method: A medical file audit was used to collect data on premorbid, entry, treatment and 18-month outcome characteristics on 661 FEP patients who consecutively attended the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, between 1998 and 2000. Functional status was ascertained using the modified vocational status index and was rated at baseline (poor or good) and according to its evolution over the treatment period (stable good, stable poor, deteriorating or improved functional status). Results: 52.0% of patients had a poor functional status at service entry. They were more likely to be male with a non-affective psychosis. They also had lower levels of premorbid global functioning and education, and were more likely to have self-reported histories of learning disability, forensic issues, traumatic experiences and substance use. At service entry, they had more severe symptoms and poorer global functioning. 37% of these patients maintained a poor functional status at discharge, and 18% of those with a good functional status at service entry experienced a decline. Conclusions: Although psychosocial interventions might assist a young person with FEP with working towards functional goals, for some, the impact of factors such as ongoing substance use and forensic issues on functional status needs to be addressed.
Keyword Education
First episode psychosis
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1061998
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Psychology Publications
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