Jason R Randall1, Dan Chateau2, Mark Smith3, Carole Taylor3, James Bolton4, Laurence Katz5, Elaine Burland3, Alan Katz1, Nathan C Nickel1, Jennifer Enns3, Marni Brownell1. 1. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. 2. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. Electronic address: Dan_Chateau@cpe.umanitoba.ca. 3. Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. 4. Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada. 5. Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada.
Abstract
BACKGROUND: Early interventions for psychosis have been shown to reduce psychotic symptoms and hospital use for first-episode patients, but the effect on suicidal and criminal behaviour has not been reliably determined. This study aimed to examine whether an early intervention for psychosis program (EPPIS) reduced criminal behaviour, suicide attempts, and hospital-based service use. METHODS: The study utilized administrative data to match clients of EPPIS to historical controls. Regression was used to determine the effect of treatment by EPPIS on inpatient use, emergency department use, suicide attempts/deaths, and criminal accusations. RESULTS: A sample of 244 patients was matched to 449 controls. EPPIS patients had lower odds of being accused of a crime both during and after treatment. Suicidal behavior was less frequent among patients, both during treatment (p<0.0001) and after (HR=0.39; 95% CI: 0.17 to 0.94). During treatment there were more emergency department visits for the patients (RR=2.54; 95% CI: 1.56 to 4.58), but no difference in inpatient usage compared to controls. Post-treatment, both emergency department and inpatient usage were higher among patients. CONCLUSIONS: EPPIS patients had reduced suicide attempts and criminal accusations. Increased emergency department use could indicate that encouraging treatment during a crisis may increase service use, while reducing suicidal and criminal behaviour.
BACKGROUND: Early interventions for psychosis have been shown to reduce psychotic symptoms and hospital use for first-episode patients, but the effect on suicidal and criminal behaviour has not been reliably determined. This study aimed to examine whether an early intervention for psychosis program (EPPIS) reduced criminal behaviour, suicide attempts, and hospital-based service use. METHODS: The study utilized administrative data to match clients of EPPIS to historical controls. Regression was used to determine the effect of treatment by EPPIS on inpatient use, emergency department use, suicide attempts/deaths, and criminal accusations. RESULTS: A sample of 244 patients was matched to 449 controls. EPPIS patients had lower odds of being accused of a crime both during and after treatment. Suicidal behavior was less frequent among patients, both during treatment (p<0.0001) and after (HR=0.39; 95% CI: 0.17 to 0.94). During treatment there were more emergency department visits for the patients (RR=2.54; 95% CI: 1.56 to 4.58), but no difference in inpatient usage compared to controls. Post-treatment, both emergency department and inpatient usage were higher among patients. CONCLUSIONS: EPPIS patients had reduced suicide attempts and criminal accusations. Increased emergency department use could indicate that encouraging treatment during a crisis may increase service use, while reducing suicidal and criminal behaviour.
Authors: Jason Randall; Dan Chateau; James M Bolton; Mark Smith; Laurence Katz; Elaine Burland; Carole Taylor; Nathan C Nickel; Jennifer Enns; Alan Katz; Marni Brownell Journal: PLoS One Date: 2017-06-07 Impact factor: 3.240
Authors: Ingrid S Sketris; Nancy Carter; Robyn L Traynor; Dorian Watts; Kim Kelly Journal: Pharmacoepidemiol Drug Saf Date: 2019-02-20 Impact factor: 2.890