TY - JOUR TI - The Epidemiology of First-Episode Psychosis in Early Intervention in Psychosis Services: Findings From the Social Epidemiology of Psychoses in East Anglia [SEPEA] Study AU - Kirkbride, James B. AU - Hameed, Yasir AU - Ankireddypalli, Gayatri AU - Ioannidis, Konstantinos AU - Crane, Carolyn M. AU - Nasir, Mukhtar AU - Kabacs, Nikolett AU - Metastasio, Antonio AU - Jenkins, Oliver AU - Espandian, Ashkan AU - Spyridi, Styliani AU - Ralevic, Danica AU - Siddabattuni, Suneetha AU - Walden, Ben AU - Adeoye, Adewale AU - Perez, Jesus AU - Jones, Peter B. T2 - The American Journal of Psychiatry AB - OBJECTIVE: Few studies have characterized the epidemiology of first-episode psychoses in rural or urban settings since the introduction of early intervention psychosis services. To address this, the authors conducted a naturalistic cohort study in England, where such services are well established. METHOD: All new first-episode psychosis cases, 16-35 years old, presenting to early intervention psychosis services in the East of England were identified during 2 million person-years follow-up. Presence of ICD-10 F10-33 psychotic disorder was confirmed using OPCRIT [operational criteria for psychotic illness]. Incidence rate ratios were estimated following multivariable Poisson regression, adjusting for age, sex, ethnicity, socioeconomic status, neighborhood-level deprivation, and population density. RESULTS: Of 1,005 referrals, 687 participants (68.4%) fulfilled epidemiological and diagnostic criteria for first-episode psychosis (34.0 new cases per 100,000 person-years; 95% CI=31.5-36.6). Median age at referral was similar for men (22.5 years; interquartile range: 19.5-26.7) and women (23.4 years; interquartile range: 19.5-29.1); incidence rates were highest for men and women before 20 years of age. Rates increased for ethnic minority groups (incidence rate ratio: 1.4; 95% CI=1.1-1.6), as well as with lower socioeconomic status (incidence rate ratio: 1.3; 95% CI=1.2-1.4) and in more urban (incidence rate ratio: 1.4;95%CI=1.0-1.8) and deprived (incidence rate ratio: 2.1; 95% CI=1.3-3.3) neighborhoods, after adjustment for confounders. CONCLUSIONS: Pronounced variation in psychosis incidence, peaking before 20 years old, exists in populations served by early intervention psychosis services. Excess rates were restricted to urban and deprived communities, suggesting that a threshold of socioenvironmental adversity may be necessary to increase incidence. This robust epidemiology can inform service development in various settings about likely population-level need. DA - 2017/02/01/ PY - 2017 DO - 10.1176/appi.ajp.2016.16010103 DP - PubMed VL - 174 IS - 2 SP - 143 EP - 153 J2 - Am J Psychiatry LA - eng SN - 1535-7228 ST - The Epidemiology of First-Episode Psychosis in Early Intervention in Psychosis Services UR - https://pubmed.ncbi.nlm.nih.gov/27771972/ KW - Adolescent KW - Adult KW - Community Mental Health KW - Cross-Sectional Studies KW - Early Medical Intervention KW - England KW - Epidemiology KW - Female KW - Highlight KW - Humans KW - Male KW - Outcome and Process Assessment (Health Care) KW - Psychosis KW - Psychotic Disorders KW - Referral and Consultation KW - Rural Population KW - SEPEA KW - Schizophrenia KW - Urban Population KW - Young Adult KW - appi.ajp.2016.1 ER -