The proportion of people with a first episode of psychosis admitted to hospital at initial presentation: A systematic review and meta-analysis

Gannon, Louisa, Teague, Victoria, Oduola, Sheri, McNicholas, Fiona, Clarke, Mary, McWilliams, Stephen and O'Donoghue, Brian (2025) The proportion of people with a first episode of psychosis admitted to hospital at initial presentation: A systematic review and meta-analysis. Psychological Medicine, 55. ISSN 0033-2917

Preview

PDF (Gannon_etal_2025_PsychologicalMedicine) - Published Version Available under License Creative Commons Attribution. Download (4MB) | Preview

Abstract

Background: In psychiatry, there is a drive to reduce institutionalization, the risk of which starts with the index admission. In first-episode psychosis (FEP), the proportion of people admitted to hospital at initial presentation is still unknown. Methods: This systematic review aimed to determine the proportion of people with FEP who are admitted at initial presentation (within 30 days from point of first contact with psychiatry) and the influence of individual, clinical, and service factors on admission risk. Four databases were searched from inception until June 2023: PubMed, Embase, PsycINFO, and CINAHL. The pooled proportion of people admitted was calculated using a random-effects model. Analyses were further stratified according to individual, clinical, and service factors. Results: Of 7,455 abstracts screened, 18 studies with 19,854 participants were included. The proportion of people admitted overall was 51% (k = 18, 95% confidence interval [CI]: 37–65%; I2: 99.56%). The proportion admitted involuntarily was 31% (k = 6, 95% CI: 23–40%; I2: 95.26%). Sub-analyses for sex, diagnosis, and early intervention service access did not show significant differences between groups. The proportion of people with a short duration of untreated psychosis (DUP) admitted was 59% (k = 2, 95% CI: 56–63%) vs. 37% (k = 2, 95% CI: 33–41%) for long DUP, which was significant (p < 0.001). High inter-study heterogeneity was observed. Conclusions: Results demonstrate that over half of the people are hospitalized when initially presenting for FEP, a high proportion, with consequences for individuals and health services at large. First, service contact must be prioritized as an opportunity for appropriate intervention, to either avoid unwarranted hospitalizations or if hospitalization is required, to ensure the application of focused therapeutic objectives within intended timeframes.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Depositing User:	LivePure Connector
Date Deposited:	26 Aug 2025 09:30
Last Modified:	26 Aug 2025 09:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100232
DOI:	10.1017/S0033291725101256

Downloads

Actions (login required)

View Item