Clare Knight1, Debra Russo2, Jan Stochl3, Tim Croudace4, David Fowler5, Nick Grey6, Nesta Reeve7, Peter B Jones8, Jesus Perez9. 1. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK. Electronic address: ck462@medschl.cam.ac.uk. 2. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK. Electronic address: dr335@medschl.cam.ac.uk. 3. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK; National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, Douglas House, Trumpinton Road, Cambridge, CB2 8AH, UK. Electronic address: js883@cam.ac.uk. 4. School of Nursing and Health Sciences, University of Dundee, Dundee, DD1 4HJ, UK. Electronic address: t.j.croudace@dundee.ac.uk. 5. School of Psychology, Pevensey Building, University of Sussex, Brighton, BN1 9QH, UK. Electronic address: d.fowler@sussex.ac.uk. 6. Sussex Partnership NHS Foundation Trust, Aldrington House, 35 New Church Road, Hove, BN3 4AG, UK. Electronic address: nick.grey@sussexpartnership.nhs.uk. 7. Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE, UK. Electronic address: Nesta.Reeve@nsft.nhs.uk. 8. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK; National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, Douglas House, Trumpinton Road, Cambridge, CB2 8AH, UK; Cambrigeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, CB21 5EF, UK. Electronic address: pbj21@cam.ac.uk. 9. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK; National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, Douglas House, Trumpinton Road, Cambridge, CB2 8AH, UK; Cambrigeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, CB21 5EF, UK; Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ. Electronic address: jesus.perez@cpft.nhs.uk.
Abstract
BACKGROUND: Psychotic experiences (PE) may co-occur with common mental disorders (CMD), such as depression and anxiety. However, we know very little about the prevalence of and recovery from PE in primary mental health care settings, such as the Improving Access to Psychological Therapies (IAPT) services in the UK National Health Service (NHS), where most CMD are treated. METHODS: We used the Community Assessment of Psychic Experiences - Positive 15-item Scale (CAPE-P15) to determine the prevalence of PE in patients receiving treatment from IAPT services. Patient-reported measures of depression (PHQ-9) and anxiety (GAD-7) are routinely collected and establish recovery in IAPT services. We studied recovery rates according to the absence and presence of PE. Multi-group growth models estimated improvement trajectories for each group. RESULTS: A total of 2,042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The overall prevalence of PE was 29.68%. The recovery rate was 27.43% compared to 62.08% for those without PE. Although patients with or without PE shared similar improvement trajectories, the initial severity of patients with PE impeded their likelihood of recovery. LIMITATIONS: We mirrored routine data collection in IAPT services, including self-report questionnaires that may affect valid reporting of symptoms. Missing data in the calculation of improvement trajectories may reduce generalisability. CONCLUSIONS: At least one in four patients receiving treatment from IAPT services in primary care experience CMD and PE. This significant group of people experience a lower recovery rate, with adverse implications not only for them but also for efficiency of services.
BACKGROUND:Psychotic experiences (PE) may co-occur with common mental disorders (CMD), such as depression and anxiety. However, we know very little about the prevalence of and recovery from PE in primary mental health care settings, such as the Improving Access to Psychological Therapies (IAPT) services in the UK National Health Service (NHS), where most CMD are treated. METHODS: We used the Community Assessment of Psychic Experiences - Positive 15-item Scale (CAPE-P15) to determine the prevalence of PE in patients receiving treatment from IAPT services. Patient-reported measures of depression (PHQ-9) and anxiety (GAD-7) are routinely collected and establish recovery in IAPT services. We studied recovery rates according to the absence and presence of PE. Multi-group growth models estimated improvement trajectories for each group. RESULTS: A total of 2,042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The overall prevalence of PE was 29.68%. The recovery rate was 27.43% compared to 62.08% for those without PE. Although patients with or without PE shared similar improvement trajectories, the initial severity of patients with PE impeded their likelihood of recovery. LIMITATIONS: We mirrored routine data collection in IAPT services, including self-report questionnaires that may affect valid reporting of symptoms. Missing data in the calculation of improvement trajectories may reduce generalisability. CONCLUSIONS: At least one in four patients receiving treatment from IAPT services in primary care experience CMD and PE. This significant group of people experience a lower recovery rate, with adverse implications not only for them but also for efficiency of services.
Authors: Fiona Kehinde; Aamena Valiji Bharmal; Ian M Goodyer; Raphael Kelvin; Bernadka Dubicka; Nick Midgley; Peter Fonagy; Peter B Jones; Paul Wilkinson Journal: Eur Child Adolesc Psychiatry Date: 2021-01-11 Impact factor: 5.349
Authors: Polly-Anna Ashford; Clare Knight; Margaret Heslin; Allan B Clark; Mona Kanaan; Ushma Patel; Freya Stuart; Thomas Kabir; Nick Grey; Hannah Murray; J Hodgekins; Nesta Reeve; Nicola Marshall; Michelle Painter; James Clarke; Debra Russo; Jan Stochl; Maria Leathersich; Martin Pond; David Fowler; Paul French; Ann Marie Swart; Mary Dixon-Woods; Sarah Byford; Peter B Jones; Jesus Perez Journal: BMJ Open Date: 2022-06-22 Impact factor: 3.006