Olesya Ajnakina1,2, Brendon Stubbs3,4, Emma Francis3, Fiona Gaughran5,6, Anthony S David7, Robin M Murray5,8, John Lally5,9,10. 1. Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, UK. 2. Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK. 3. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. 5. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 6. National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK. 7. Institute of Mental Health, University College London, London, UK. 8. Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, PalermoPA, Italy. 9. Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland. 10. Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland.
Abstract
BACKGROUND: Reducing hospitalisation and length of stay (LOS) in hospital following first episode psychosis (FEP) is important, yet reliable measures of these outcomes and their moderators are lacking. We conducted a systematic review and meta-analysis to investigate the proportion of FEP cases who were hospitalised after their first contact with services and the LOS in a hospital during follow-up. METHODS: Studies were identified from a systematic search across major electronic databases from inception to October 2017. Random effects meta-analyses and meta-regression analyses were conducted. RESULTS: 81 longitudinal studies encompassing data for 23 280 FEP patients with an average follow-up length of 7 years were included. 55% (95% CI 50.3-60.5%) of FEP cases were hospitalised at least once during follow-up with the pooled average LOS of 116.7 days (95% CI 95.1-138.3). Older age of illness onset and being in a stable relationship were associated with a lower proportion of people who were hospitalised. While the proportion of hospitalised patients has not decreased over time, LOS has, with the sharpest reduction in the latest time period. The proportion of patients hospitalised during follow-up was highest in Australia and New Zealand (78.4%) compared to Europe (58.1%) and North America (48.0%); and lowest in Asia (32.5%). Black ethnicity and longer duration of untreated psychosis were associated with longer LOS; while less severe psychotic symptoms at baseline were associated with shorter LOS. CONCLUSION: One in two FEP cases required hospitalisation at least once during a 7-year follow-up with an average length of hospitalisation of 4 months during this period. LOS has declined over time, particularly in those countries in which it was previously longest.
BACKGROUND: Reducing hospitalisation and length of stay (LOS) in hospital following first episode psychosis (FEP) is important, yet reliable measures of these outcomes and their moderators are lacking. We conducted a systematic review and meta-analysis to investigate the proportion of FEP cases who were hospitalised after their first contact with services and the LOS in a hospital during follow-up. METHODS: Studies were identified from a systematic search across major electronic databases from inception to October 2017. Random effects meta-analyses and meta-regression analyses were conducted. RESULTS: 81 longitudinal studies encompassing data for 23 280 FEP patients with an average follow-up length of 7 years were included. 55% (95% CI 50.3-60.5%) of FEP cases were hospitalised at least once during follow-up with the pooled average LOS of 116.7 days (95% CI 95.1-138.3). Older age of illness onset and being in a stable relationship were associated with a lower proportion of people who were hospitalised. While the proportion of hospitalised patients has not decreased over time, LOS has, with the sharpest reduction in the latest time period. The proportion of patients hospitalised during follow-up was highest in Australia and New Zealand (78.4%) compared to Europe (58.1%) and North America (48.0%); and lowest in Asia (32.5%). Black ethnicity and longer duration of untreated psychosis were associated with longer LOS; while less severe psychotic symptoms at baseline were associated with shorter LOS. CONCLUSION: One in two FEP cases required hospitalisation at least once during a 7-year follow-up with an average length of hospitalisation of 4 months during this period. LOS has declined over time, particularly in those countries in which it was previously longest.
Entities:
Keywords:
First episode psychosis; follow-up; hospitalisation; inpatient; length of stay; outcome; schizophrenia
Authors: Nikolaos Koutsouleris; Lana Kambeitz-Ilankovic; Shalaila S Haas; Linda A Antonucci; Julian Wenzel; Anne Ruef; Bruno Biagianti; Marco Paolini; Boris-Stephan Rauchmann; Johanna Weiske; Joseph Kambeitz; Stefan Borgwardt; Paolo Brambilla; Eva Meisenzahl; Raimo K R Salokangas; Rachel Upthegrove; Stephen J Wood Journal: Neuropsychopharmacology Date: 2020-10-07 Impact factor: 7.853
Authors: Olesya Ajnakina; Victoria Rodriguez; Diego Quattrone; Marta di Forti; Evangelos Vassos; Celso Arango; Domenico Berardi; Miguel Bernardo; Julio Bobes; Lieuwe de Haan; Cristina Marta Del-Ben; Charlotte Gayer-Anderson; Hannah E Jongsma; Antonio Lasalvia; Sarah Tosato; Pierre-Michel Llorca; Paulo Rossi Menezes; Bart P Rutten; Jose Luis Santos; Julio Sanjuán; Jean-Paul Selten; Andrei Szöke; Ilaria Tarricone; Giuseppe D'Andrea; Alexander Richards; Andrea Tortelli; Eva Velthorst; Peter B Jones; Manuel Arrojo Romero; Caterina La Cascia; James B Kirkbride; Jim van Os; Mick O'Donovan; Robin M Murray Journal: Schizophr Bull Date: 2021-10-21 Impact factor: 9.306