Mental health antecedents in first episode of psychosis: impact on prognosis across transitional age

The beneficial effects of reducing the duration of untreated psychosis on longitudinal outcomes has led to implement early intervention programs during prodromal phase, especially for young people. However, little is known about psychiatric antecedents in people experiencing First Episode Psychosis (FEP). This study aimed (1) to calculate the proportion of FEP participants with previous contact with Child/Adolescent or/and Adult Mental Healthcare Services (CAMHS/AMHS) recruited within a specialized "Early Intervention in Psychosis" service, and (2) to compare sociodemographic, clinical, and treatment parameters between FEP patients with and without psychiatric antecedents across a 2-year follow-up period. At baseline, all participants (aged 12-35 years) completed the Health of the Nation Outcome Scale (HoNOS). A mixed-design ANOVA and a Kaplan-Meier survival analysis were used. The prevalence of antecedents in our FEP population was 48%. 15% had previous contact with CAMHS and only 21% of them experienced care continuity transitioning to AMHS. The most common past diagnoses in the FEP/CAMHS subgroup were conduct disorder (43.4%) and learning disorder (26.3%). Differently, the FEP/AMHS subgroup more frequently had personality disorder (50.8%) and anxious-depressive disorder (35.9%). FEP/CAMHS individuals had higher baseline HoNOS "Psychiatric symptoms" factor score and received higher total number of family psychoeducation sessions than the other subgroups. Our results suggest the importance of enhancing strategies for a better transition for adolescents. Indeed, this population appears to be at risk for higher psychiatric symptoms detected with HoNOS when developing psychosis.