Access to Psychological Interventions and the Associated Factors in Early Psychosis

Schjølberg Marques, Sara (2025) Access to Psychological Interventions and the Associated Factors in Early Psychosis. Doctoral thesis, University of East Anglia.

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Abstract

Early intervention in psychosis is crucial for improving outcomes. Sleep disturbances and socio-occupational functioning (SOF) are recognised as key factors in early psychosis and may influence treatment targets, yet their complex interplay remains underexplored in individuals with an At-Risk Mental State (ARMS) and First-Episode Psychosis (FEP). Furthermore, the COVID-19 pandemic disrupted mental health services worldwide, posing potential barriers to timely access to care. This thesis aims to examine both the association between sleep and SOF in early psychosis and the impact of the pandemic on access to psychological interventions across sociodemographic groups.

A systematic review synthesised evidence from 13 studies investigating the relationship between sleep disturbances and SOF in ARMS and FEP populations, as well as the potential benefits of psychological sleep interventions. An empirical study retrospectively analysed 7,920 de-identified electronic clinical records from the South London and Maudsley NHS Foundation Trust, assessing changes in access to psychological interventions before, during, and after the pandemic using interrupted time series study design and logistic regression analyses.

Findings indicate that sleep disturbances are significantly associated with socio-occupational impairment, and interventions targeting sleep may indirectly enhance functioning. Meanwhile, the pandemic led to a sustained reduction in access to psychological interventions, with individuals from minoritised ethnic groups and socioeconomically disadvantaged backgrounds disproportionately affected.

These results highlight the need for integrated mental health care that considers sleep as a modifiable target for improving socio-occupational outcomes in early psychosis. Furthermore, service adaptations and targeted strategies are necessary to address disparities in access to psychological support, ensuring equitable early intervention. Future research could explore long-term impacts and the development of tailored interventions to enhance both sleep and treatment accessibility in this population.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	29 Oct 2025 14:33
Last Modified:	29 Oct 2025 14:33
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100835
DOI:

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