Site maintenance Wednesday, November 13th, 2024. Please note that access to some content and account information will be unavailable on this date.
Full access
Articles
Published Online: 14 May 2019

Predictors of Hospitalization of Individuals With First-Episode Psychosis: Data From a 2-Year Follow-Up of the RAISE-ETP

Delbert G. Robinson, M.D. [email protected], Nina R. Schooler, Ph.D., Robert A. Rosenheck, M.D., Haiqun Lin, M.D., Ph.D., Kyaw J. Sint, Ph.D., Patricia Marcy, B.S.N., and John M. Kane, M.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 70, Number 7
https://doi.org/10.1176/appi.ps.201800511
Track CitationsAdd to favorites
PDF/EPUBFormats

Abstract

Objective:

Despite treatment advances in other domains, inpatient psychiatric hospitalization rates for individuals with first-episode psychosis remain high. Even with early intervention services, a third or more of individuals are hospitalized over the first 2 years of treatment. Reducing hospitalization is desirable from the individual’s perspective and for public health reasons because hospitalization costs are a major component of treatment costs.

Methods:

Univariate and multivariate baseline and time-varying covariate analyses were conducted to identify predictors of hospitalization in the Recovery After an Initial Schizophrenia Episode–Early Treatment Program (RAISE-ETP) study, a 2-year cluster randomized trial for participants experiencing a first episode of psychosis who were outpatients at study entry. The trial compared an early intervention treatment model (NAVIGATE) with usual community care at 34 clinics across the United States.

Results:

RAISE-ETP enrolled 404 participants of whom 382 had one or more postbaseline assessments that included hospitalization data. Thirty-four percent of NAVIGATE and 37% of usual-care participants were hospitalized during the trial. Risk analyses revealed significant predictors of hospitalization to be the number of hospitalizations before study entry; duration of untreated psychosis; and time-varying days of substance misuse, presence of positive symptoms, and beliefs about the value of medication.

Conclusions:

These results indicate that hospital use may be decreased by reducing the duration of untreated psychosis and prior hospitalizations, minimizing residual symptoms, preventing substance misuse, and facilitating adherence to medication taking. Addressing these factors could enhance the impact of first-episode early intervention treatment models and also enhance outcomes of people with first-episode psychosis treated using other models.

Formats available

You can view the full content in the following formats:

View PDF/EPUBView Full Text

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: XXXX

Psychiatric Services
Volume 70 • Number 7 • July 01, 2019
Pages: 569 - 577
PubMed: 31084291

History

Received: 12 November 2018
Revision received: 25 January 2019
Accepted: 14 February 2019
Published online: 14 May 2019
Published in print: July 01, 2019

Keywords

  1. hospitalization
  2. adherence
  3. duration of untreated psychosis
  4. substance misuse
  5. positive symptoms
  6. first-episode psychosis

Authors

Details

Delbert G. Robinson, M.D. [email protected]
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
Nina R. Schooler, Ph.D.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
Robert A. Rosenheck, M.D.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
Haiqun Lin, M.D., Ph.D.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
Kyaw J. Sint, Ph.D.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
Patricia Marcy, B.S.N.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author
John M. Kane, M.D.
Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, Feinstein Institute for Medical Research, Manhasset, New York (Robinson, Kane); Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York (Schooler); Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut (Rosenheck); Yale School of Public Health, New Haven (Lin, Sint); Vanguard Research Group, Glen Oaks, New York (Marcy).
View all articles by this author

Notes

Send correspondence to Dr. Robinson ([email protected]).

Competing Interests

Dr. Robinson has been a consultant to Costello Medical Consulting, Innovative Science Solutions, Janssen, Neurocrine, Otsuka, and U.S. WorldMeds. Dr. Schooler has received grant support from Otsuka and has provided consultation or participated on advisory boards for Allergan, Alkermes, and Roche. Ms. Marcy is a shareholder in Pfizer and is the executive director of the Vanguard Research Group. Dr. Kane has been a consultant for or received honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intracellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, Merck, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva. He has received grant support from Otsuka, Lundbeck, and Janssen. He is also a shareholder in Vanguard Research Group and LB Pharmaceuticals, Inc. Drs. Rosenheck, Lin, and Sint report no financial relationships with commercial interests.

Funding Information

National Institute of Mental Health10.13039/100000025: HHSN271200900019C, P30MH090590
This work has been funded in whole or in part with funds from the American Recovery and Reinvestment Act and from the National Institute of Mental Health (NIMH) under contract HHSN271200900019C. Additional support for these analyses was provided by an NIMH Advanced Centers for Intervention and/or Services Research award (P30MH090590).

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard
Tips for downloading citations

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Item saved, go to cart
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share

×

As described within the American Psychiatric Association (APA)'s Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences. Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.