Why are we doing this research?
1. The NHS has made a huge investment in establishing early intervention programmes for individuals suffering their first psychotic episode. These programmes are premised on the idea that early intervention is particularly effective and that shortening the duration of untreated psychosis will improve long-term outcome. However, the evidence for this over the medium- to long-term is limited, and there is little information in general about what factors predict outcome.
2. There are numerous reports of high rates of psychosis in the African-Caribbean, and increasingly the Black African, populations in the UK. Furthermore, a disproportionate number of African-Caribbeans and Black Africans so diagnosed are admitted to psychiatric units compulsorily; they are also eight times more likely to be detained in high security psychiatric hospitals. These findings have provoked much controversy, and understanding how psychosis develops over time in different ethnic groups, and how sufferers interact with services, is essential for the development of effective interventions that are targeted at those most in need.
Following from the above, this project has two aims:
1. To identify the factors that predict the course and outcome of psychosis following a first episode, focusing specifically on the role of biological and social risk indicators, cannabis use, and duration of untreated psychosis (DUP).
2. To study and explain the differences in the course and outcome of psychosis in Black and White patients in the decade following a first episode.
What are we doing?
To meet these aims, we are following and re-assessing at ten years of a unique epidemiologically-based cohort of 535 individuals initially studied during their first episode of psychosis (AESOP study). Data is being collated where possible on all initial participants at ten years on outcomes in three domains (clinical course and outcome; social disability; mental health service use) and we are repeating assessments of brain structure (repeat magnetic resonance image) and neurocognition. In addition, we are collecting information on substance use, family history of psychosis, coping strategies, satisfaction with mental health services and medication use.
Some data is being used to re-contact patients for a further follow-up. This follow-up is part of a larger study called STRATA.
Who is involved?
Principal Investigators: Professor Sir Robin Murray, Dr Craig Morgan, Dr Paola Dazzan, Professor Paul Fearon, Professor Peter Jones, Dr Tim Croudace, Dr Gillian Doody
Principal Researchers: Dr Julia Lappin, Margaret Heslin
PhD student (part-time): Jolanta Zanelli
Collaborators: Professor Julian Leff, Dr Gerard Hutchinson, Dr Avi Reichenberg, Dr Diana Rose