Clare Graham

and 4 more

Introduction: Quality of Life (QoL) is an important outcome measure for people with a first episode psychosis (FEP). Despite high numbers of patients being admitted to psychiatric hospitals following an FEP, the impact of hospital admission on outcome measures such as QoL is under-investigated. This study aimed to systematically review evidence of the impact of hospital admission on QoL in patients with an FEP. Methods: A systematic review was conducted in line with the PRISMA Guidelines. PsychINFO, Medline, CINAHL and EMBASE were searched from 2000 to 2022, examining the impact of QoL for people with an FEP following a hospital admission. Quantitative, qualitative and mixed methods studies were included in the search. Study quality was assessed using the Mixed Methods Assessment Tool. Data was analysed using narrative synthesis. Results: Seven hundred and eight two abstracts were found. Fifty-three full texts were reviewed. Data was extracted for eight articles. Across the eight studies, four discrete QoL measures were employed. Results showed that QoL scores were consistent over time, with little statistical change from baseline to follow-up. Across studies, participants reported low average QoL scores. Across studies, information on the treatment components and duration of hospital admission were scarce. Conclusion: There is a relative paucity of studies that have examined QoL in relation to hospital admission. QoL scores remained consistent over time, suggesting that QoL is relatively well preserved at the first episode. Further research is needed on the impact of inpatient-based interventions in FEP.

Aisling Redmond

and 3 more

Background: Trauma plays an important role in the development and maintenance of psychosis. However, it is still under-examined in daily clinical practice. The current study investigated the rates of recording of trauma-exposure in the clinical histories of a first-episode psychosis (FEP) cohort attending an early intervention psychosis service. Methods: This study used a retrospective chart review methodology in a six-year epidemiologically complete (FEP) first-episode psychosis cohort attending an early intervention psychosis service. The Trauma and Life Events Checklist was used to define the rate and types of trauma exposure reported in clinical histories. The relationships were examined between recorded trauma-exposure and positive and negative symptoms, depression, and duration of untreated psychosis at first assessment. Results: A high rate of recorded trauma exposure was found, indicating that clinicians are recording trauma-exposure in daily practice through clinical histories. Childhood trauma exposure was recorded in 47.4% of the sample. No significant relationships between the recorded trauma-exposure and symptom measures were found. A significant relationship was found between interpersonal stressors and positive symptoms, and work-related stress and negative symptoms, highlighting the important of proximal stressful life events. Discussion: Even though clinicians were not assessing trauma systematically using standardised instruments, this study found that clinicians were recording trauma-exposure in daily practice. The high rates of trauma-exposure highlighted the need for trauma to be systematically diagnosed, assessed and treated in planning services for people with psychosis. This study found no significant relationship between recorded trauma-exposure and symptomology.