Incidence of treated first episode psychosis from an Australian early intervention service and its association with neighbourhood characteristics

Eaton, Scott; Harrap, Benjamin; Downey, Linglee; Thien, Kristen; Bowtell, Meghan; Bardell-Williams, Melissa; Ratheesh, Aswin; McGorry, Patrick D.; O’Donoghue, Brian

doi:10.1016/j.schres.2019.04.017

Cited by 29 publications

(18 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We have previously argued that mental health services and early intervention for psychosis services should be funded according to the predicted incidence rates of first-episode psychosis, as opposed to per-capita funding (Eaton et al, 2019). The findings from this study also support such a model, as communities in which higher proportions of migrants from the aforementioned African countries or Afghanistan would manifest higher treated incidence rates of psychotic disorder, and should therefore receive the appropriate funding based on local population need to reduce public mental health inequalities.…”

Section: Discussionmentioning

confidence: 99%

Risk of psychotic disorders in migrants to Australia

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Certain migrant groups are at an increased risk of psychotic disorders compared to the native-born population; however, research to date has mainly been conducted in Europe. Less is known about whether migrants to other countries, with different histories and patterns of migration, such as Australia, are at an increased risk for developing a psychotic disorder. We tested this for first-generation migrants in Melbourne, Victoria. Methods This study included all young people aged 15–24 years, residing in a geographically-defined catchment area of north western Melbourne who presented with a first episode of psychosis (FEP) to the Early Psychosis Prevention and Intervention Centre (EPPIC) between 1 January 2011 and 31 December 2016. Data pertaining to the at-risk population were obtained from the Australian 2011 Census and incidence rate ratios were calculated and adjusted for age, sex and social deprivation. Results In total, 1220 young people presented with an FEP during the 6-year study period, of whom 24.5% were first-generation migrants. We found an increased risk for developing psychotic disorder in migrants from the following regions: Central and West Africa (adjusted incidence rate ratio [aIRR] = 3.53, 95% CI 1.58–7.92), Southern and Eastern Africa (aIRR = 3.06, 95% CI 1.99–4.70) and North Africa (aIRR = 5.03, 95% CI 3.26–7.76). Migrants from maritime South East Asia (aIRR = 0.39, 95% CI 0.23–0.65), China (aIRR = 0.25, 95% CI 0.13–0.48) and Southern Asia (aIRR = 0.44, 95% CI 0.26–0.76) had a decreased risk for developing a psychotic disorder. Conclusion This clear health inequality needs to be addressed by sufficient funding and accessible mental health services for more vulnerable groups. Further research is needed to determine why migrants have an increased risk for developing psychotic disorders.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk of psychotic disorders in migrants to Australia

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The incidence rate of FEP is high within this catchment area, with a treated incidence study identifying that there were over 100 cases per 100,000 of the at-risk population (i.e. those aged 15-24 years; Eaton et al, 2019).…”

Section: Catchment Areamentioning

confidence: 97%

The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia

O’Donoghue

Collett

Boyd

et al. 2021

Aust N Z J Psychiatry

Self Cite

View full text Add to dashboard Cite

Objective: The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission). Methods: Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared. Results: Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]). Conclusion: There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.

show abstract

“…The EPPIC service was one of the first EI services in the world and was established in 1992 (McGorry et al, 1996). The catchment area covers 59 postcodes in the north-western and western areas of Melbourne, Australia, some of which have high levels of social deprivation and social fragmentation (Eaton et al, 2019).…”

Section: Settings and Participantsmentioning

confidence: 99%

“…All young people with a FEP aged 15 to 24 years-old, living in the catchment area and attending the EPPIC service between 01.01.2011 and 31.12.2016, were included in the study (Eaton et al, 2019;Pignon et al, 2019). In order to reduce help-seeking delays, there is an open referral system, in that young people can be referred by anyone, including themselves and the common sources of referral are family, general practitioners, school and university counsellors, private psychologists and youth workers.…”

Section: Settings and Participantsmentioning

confidence: 99%

Temporal variation in the incidence of treated psychotic disorders in young people

Pignon

Eaton

Schürhoff

et al. 2021

Schizophrenia Research

Self Cite

View full text Add to dashboard Cite

The incidence of psychotic disorders varies between geographical areas, however less is known about whether it varies over time in the same region. Analyzing this temporal variation of incidence could improve the allocation of healthcare resources and our understanding of the aetiology of psychotic disorders. This study aimed to determine whether there was a change in the incidence of psychotic disorders over a six-year period. MethodsYoung people aged 15 to 24 presenting with a first episode of psychosis (FEP) attending an early intervention service in Melbourne between 2011 and 2016 were included. The population at-risk was determined from the two corresponding census periods and analyses were adjusted for age, sex and migrant status. ResultsA total of 1217 young people presented with a FEP over the six-year period and the crude incidence rate in 2011 was 102.4 per 100,000 population at-risk, compared to 125.4 in 2016.There was an increase in the incidence by 33% in 2015 (aIRR=1.33, 95% CI 1.09-1.63) and 28% in 2016 (aIRR=1.28, 95% CI 1.05-1.56). When examined according to diagnostic groups, there was an increase in the incidence of substance-induced psychotic disorders among females in 2015 (aIRR=4.62, 95% CI 1.02-20.8). DiscussionThis study shows significant temporal variations in the incidence of treated psychotic disorders. These findings demonstrate that early intervention services should continually monitor incidence case numbers and funding should be provided accordingly, to ensure the required intensive and comprehensive treatments can be sustained.

show abstract

Incidence of treated first episode psychosis from an Australian early intervention service and its association with neighbourhood characteristics

Cited by 29 publications

References 33 publications

Risk of psychotic disorders in migrants to Australia

Risk of psychotic disorders in migrants to Australia

The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia

Temporal variation in the incidence of treated psychotic disorders in young people

Contact Info

Product

Resources

About