Aim: To investigate correlates of insight dimensions in Chinese adult patients with early psychosis. Methods: Insight dimensions including awareness of mental disorder (AMD), illness consequences (AIC) and medication effect (AME) were measured. A wide array of variables encompassing demographics, premorbid adjustment, onset profiles, symptomatology, treatment characteristics and psychological factors were comprehensively assessed.Results: Of 130 participants, 53.1%, 47.7% and 56.2% were categorized with good AMD, AIC and AME, respectively. Good AMD was associated with female gender, fewer positive and disorganization symptoms, more severe depression and greater self-stigma. Good AIC was related to female gender, more severe depression and greater self-stigma. Younger age of onset, fewer positive symptoms and greater service satisfaction associated with good AME.Conclusions: Poor insight is prevalent in early psychosis. Differential relationships of insight dimensions with other illness variables underscore the importance of multidimensional approach in insight evaluation, and suggest potential treatment target for insight enhancement.

Background Subjective quality of life (SQoL) is an important outcome domain in patients with early psychosis. In an attempt to better understand and maximize SQoL of early psychosis patients, an increasing number of research has been conducted to investigate factors associated with SQoL. Nonetheless, most previous studies focused on younger patients with early psychosis. In this study, the correlates of SQoL in adult patients who had completed 3-year specialized early intervention service for first-episode psychosis (FEP) in Hong Kong were investigated. Methods In total, one hundred and one Chinese patients aged 26–55 years who completed 3-year specialized early intervention service for psychosis in Hong Kong were recruited. Assessments on illness onset (DUP), clinical (PANSS, BNSS, SUMD), intrinsic motivation (by items in Quality of Life Scale, QLS), functional (SOFAS), antipsychotic-induced parkinsonism features (Simpson-Angus Scale, SAS) were conducted. SQoL was evaluated by Chinese version SF-12 which consist of physical and mental components for analysis. Results Correlation analyses showed that SF12 physical health score was correlated with PANSS depression component (p<0.001), QLS intrinsic motivation score (p=0.001) and SAS score (p<0.05) while SF12 mental health score was correlated with PANSS depression score (p<0.001), QLS intrinsic motivation score (p<0.05) and SAS score (p<0.05). Multiple linear regression analyses further revealed that lower PANSS depression score (p<0.001) and higher intrinsic motivation (measured by QLS, p<0.05) were independently associated with better physical SQoL, while lower PANSS depression score (p<0.001) and lower SAS side-effect score (p<0.05) were independently related to better mental SQoL. Discussion Our results are consistent with the literature which indicates that SQoL is significantly related to depressive symptoms. In addition, patients with higher intrinsic motivation and less antipsychotic-induced extrapyramidal side-effect have better SQoL. Further analysis on the longitudinal data will clarify variables predictive of SQoL at follow-up.

BackgroundA territory-wide specialized early intervention (EI) service for psychosis (EASY) has been implemented in Hong Kong since 2001, providing 2-year phase-specific early assessment and clinical care to young people aged 15–25 years presenting with first-episode psychosis (FEP). Previous evaluation demonstrated superiority of EASY programme over standard care in outcome improvement in FEP. Recently, EASY has been extended to provide 3-year EI service to FEP patients aged 15 to 64 years. However, effectiveness of EI on adult FEP populations has not been well examined.MethodsThis study adopted case versus historical-control design, comparing patients received 3-year EASY treatment (EI group) with those managed by standard psychiatric care (SC group) prior to implementation of EASY extension in terms of treatment delay and outcomes in symptom and functioning. In total, 320 Chinese adult FEP patients aged 26–55 years (160 in EI group, 160 in SC group) were included in the study. Retrospective record review detailing service utilization over 3-year treatment period was conducted. Follow-up interview assessment (on average 48.3 months after service entry) encompassing premorbid adjustment, duration of untreated psychosis (DUP), clinical (Positive and Negative Syndrome Scale, PANSS; Calgary Depression Scale, CDS), functional (Role Functioning Scale, RFS) and treatment profiles was administered. Comparison analyses on DUP and service utilization were based on record review data of 320 patients. Clinical and functional outcome analyses focused on data collected from follow-up interview assessment (251 patients completed follow-up assessment, 130 from EI and 121 from SC groups).ResultsEI and SC groups were comparable regarding demographics, premorbid and baseline characteristics, except the use of second-generation antipsychotic (SGA) treatment (EI patients were more likely to receive SGA than SC patients). EI patients had significantly shorter DUP than SC counterparts (p=0.015). Regarding follow-up outcomes, EI patients displayed lower levels of negative (p=0.044) and depressive symptoms (p=0.055), higher scores in RFS immediate social network (p=0.027) and lower rates of service disengagement (p=0.048) than SC patients even when SGA use and DUP were adjusted as covariates in analysis of covariance for comparison. There were no significant group differences in admission and suicide rates.DiscussionOur results indicate that extended EASY service achieve favorable outcomes in adult FEP patients on shortening of treatment delay and improvement in negative symptoms and social functioning, and service disengagement reduction. Further evaluation is required to assess the sustainability of positive effects.