Psychosis Early Intervention Across the Life Span: A Service Perspective

Area of Science:

• Psychiatry
• Public Health
• Clinical Psychology

Background:

• UK early intervention in psychosis (EI) services, historically youth-focused, expanded to include adults of all ages in 2016.
• This expansion necessitates understanding the distinct needs and outcomes of different age groups within these services.

Purpose of the Study:

• To compare the care offerings, clinical characteristics, and outcomes for individuals under 35 and over 35 accessing London-based EI services.
• To inform service development and ensure equitable, effective care for all age demographics.

Main Methods:

• An observational study utilizing anonymised data from London EI service users between April 2016 and December 2019.
• Descriptive statistics and comparative analyses were performed on 692 service users, with a focus on demographic and clinical variables.

Main Results:

• Over-35s (32.5% of users) were more likely to be female, have poorer physical health, and present with more severe issues (HoNOS scores) at intake.
• Under-35s showed poorer appointment attendance, higher inpatient facility use, and greater risk factors.
• Both groups demonstrated clinical improvements (HoNOS scores) by discharge.

Conclusions:

• Adults over 35 represent a substantial user group in EI services, often presenting with complex physical health needs.
• Care pathways for older adults may benefit from reduced crisis management and increased focus on recovery-oriented interventions and integrated physical healthcare.
• Service provision should be adapted to meet the specific needs of the over-35 demographic within early intervention frameworks.