Ethnic disparities, clinical and pathways to care characteristics associated with the offer, uptake, and type of psychological therapy during first-episode psychosis: examining the role of early intervention for psychosis

Oduola, Sherifat, Pathan, Samir, Hodgekins, Jo, Teague, Bonnie, Craig, Thomas K. J., Murray, Robbin and Morgan, Craig (2025) Ethnic disparities, clinical and pathways to care characteristics associated with the offer, uptake, and type of psychological therapy during first-episode psychosis: examining the role of early intervention for psychosis. Psychological Medicine, 55. ISSN 0033-2917

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Abstract

Background: Psychological therapy (PT) along with antipsychotic medication is the recommended first line of treatment for first-episode psychosis (FEP). We investigated whether ethnicity, clinical, pathways to care (PtC) characteristics, and access to early intervention service (EIS) influenced the offer, uptake, and type of PT in an FEP sample. Methods: We used data from the Clinical Record Interactive Search-First Episode Psychosis study. Inferential statistics determined associations between ethnicity, clinical, PtC, and PT offer/uptake. Multivariable logistic regression estimated the odds of being offered a PT and type of PT by ethnicity, clinical and PtC characteristics adjusting for confounders. Results: Of the 558 patients included, 195 (34.6%) were offered a PT, and 193 accepted. Cognitive behavioral therapy (CBT) (n = 165 of 195; 84.1%) was commonly offered than group therapy (n = 30 of 195; 13.3%). Patients who presented via an EIS (adj. OR = 2.24; 95%CI 1.39–3.59) were more likely to be offered a PT compared with those in non-EIS. Among the patients eligible for an EIS, Black African (adj. OR = 0.49; 95%CI = 0.25–0.94), Black Caribbean (adj. OR = 0.45; 95%CI = 0.21–0.97) patients were less likely to be offered CBT compared with their White British counterparts. Patients with a moderate onset of psychosis (adj. OR = 0.34; 95%CI = 0.15–0.73) had a reduced likelihood of receiving CBT compared with an acute onset. Conclusions: Accessing EIS during FEP increased the likelihood of being offered a PT. However, treatment inequalities remain by ethnicity and clinical characteristics.

Item Type:	Article
Additional Information:	Data availability statement: No additional data are available. Funding statement: CM was supported by UK Medical Research Council (Ref: G0500817), the Wellcome Trust (Grant Number: WT087417), and the European Union (European Community’s Seventh Framework Program (grant agreement No. HEALTH-F2–2009-241909) (Project EU-GEI)). SO and CM are supported by the National Institute for Health Research [NIHR 207498]. The views expressed are those of the authors and not necessarily those of the funding bodies.
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	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 Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Groups > Mental Health
Depositing User:	LivePure Connector
Date Deposited:	08 Sep 2025 10:30
Last Modified:	08 Sep 2025 10:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100302
DOI:	10.1017/S0033291725101529

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