Prison and Community Populations at Ultra-High Risk of Psychosis: Differences and Challenges for Service Provision.

Objective: The aim of the study was to explore the feasibility of expanding a community service for early detection of psychosis into a local London prison for men in the United Kingdom.

Methods: All new receptions to a local prison for men in South London were approached for routine screening. Those who met criteria for being at ultra-high-risk of psychosis were compared with a help-seeking sample from the community who met the same criteria.

Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

In addition to attenuated psychotic symptoms, individuals at high clinical risk of developing psychosis display a wide range of psychopathological features. Some of these may be subjectively perceived as more troubling than others and may therefore be more likely to trigger help-seeking behavior. We aimed at investigating the nature and prevalence of symptoms subjectively considered most distressing by high-risk individuals at the time of their presentation to early recognition services and to determine their impact on baseline and longitudinal functional and clinical outcomes.

Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase.

Background: It is unknown whether prodromal services improve outcomes in those who go on to develop psychosis, and whether these patients are demographically different from the overall first-episode population.

Aims: To compare sociodemographic features, duration of untreated psychosis, hospital admission and frequency of compulsory treatment in the first year after the onset of psychosis in patients who present to prodromal services with patients who did not present to services until the first episode of psychosis.

Method: We compared two groups of patients with first-episode psychosis: one who made transition after presenting in the prodromal phase and the other who had presented with a first episode.

The impact of delivering GP training on the clinical high risk and first-episode psychosis on referrals and pathways to care.

Aim: This project explored the impact of a general practitioner (GP) training programme on referrals and pathways to care for people at high clinical risk of psychosis or with a first-episode psychosis. The resources needed to deliver the training were measured to help inform other teams considering this approach. Satisfaction with the training was also explored.