Olesya Ajnakina1, Craig Morgan2, Charlotte Gayer-Anderson2, Sherifat Oduola3, François Bourque2, James MacCabe1, Paola Dazzan1, Robin Murray1, Anthony David1; 1Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, 2Society and Mental Health Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK, 3David Goldberg Building, Institute of Psychiatry, Psychology & Neuroscience, Kings College London
Little is known about patients with a first episode of psychosis (FEP) who had first presented to prodromal services with an “at risk mental state” (ARMS) before making the transition to psychosis. We set out to identify the proportion of patients with a FEP who had first presented to the prodromal services in the ARMS state. We further sought to compare FEP patients with and without prior contact with prodromal services. In this study 338 patients aged ≤37 years who presented to mental health services between 2010 and 2012 with a FEP were employed. The data on pathways to care, clinical and socio-demographic characteristics were extracted from the Biomedical Research Council Case Register for South London and Maudsley NHS Trust. Over 2 years, 55 (16.3% of 338) young adults presented with FEP and had been seen previously by the prodromal services. Of these, 14 (4.1% of 338) had met criteria for the ARMS when seen in a prodromal service and 41 (12.1% of 338) were already psychotic. The true ARMS patients were more likely to enter their pathway to care via referral from General Practice, be born in the UK and to have had an insidious mode of illness onset than FEP patients without prior contact with the prodromal services. In the current pathways to care configuration, prodromal services are likely to prevent only a few at-risk individuals from transitioning to psychosis even if effective preventative treatments become available.
