More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider
Background Psychotic experiences may emerge in more severe cases of common mental disorders (CMD). Previous work identified that 30% of patients treated by mental health services in primary healthcare, specifically the Improving Access to Psychological Therapies (IAPT) programme in England, reported...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2020-11-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472420001209/type/journal_article |
| _version_ | 1811157037929725952 |
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| author | Clare Knight Debra Russo Jan Stochl Peter B. Jones Jesus Perez |
| author_facet | Clare Knight Debra Russo Jan Stochl Peter B. Jones Jesus Perez |
| author_sort | Clare Knight |
| collection | DOAJ |
| description | Background
Psychotic experiences may emerge in more severe cases of common mental disorders (CMD). Previous work identified that 30% of patients treated by mental health services in primary healthcare, specifically the Improving Access to Psychological Therapies (IAPT) programme in England, reported psychotic experiences, began treatment with more severe CMD and were less likely to reach recovery.
Aims
To replicate our previous assessment of psychotic experiences in the IAPT programme using a more sensitive threshold and determine its impact on the prevalence of psychotic experience and likelihood of recovery. Additionally, to compare recovery rates between patients with and without psychotic experiences at the end of therapy.
Method
The Community Assessment of Psychic Experiences (CAPE-P15) with a cut-off of 1.30 was used to determine the prevalence of psychotic experiences. Recovery rates were determined using measures collected in the IAPT programme for depression (PHQ-9) and anxiety (GAD-7). Multi-group growth models estimated improvement trajectories.
Results
In total, 2042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The prevalence of psychotic experiences was 18% higher when using a lower threshold. The recovery rate for patients with psychotic experiences was lower (36%) than for those without (64%). Despite sharing similar improvement trajectories, the higher initial severity of CMD among patients with psychotic experiences impeded likelihood of recovery.
Conclusions
As psychotic experiences may be a marker of severity in CMD, the benefits of identifying these in IAPT populations may also apply to patients with milder experiences. Further investigation of the consequential demands on service provision and how this would affect clinical practice is recommended.
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| first_indexed | 2024-04-10T04:59:30Z |
| format | Article |
| id | doaj.art-be35e54d297a4efda06f6c85045e34d3 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:30Z |
| publishDate | 2020-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-be35e54d297a4efda06f6c85045e34d32023-03-09T12:29:03ZengCambridge University PressBJPsych Open2056-47242020-11-01610.1192/bjo.2020.120More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net widerClare Knight0Debra Russo1Jan Stochl2https://orcid.org/0000-0002-9693-9930Peter B. Jones3Jesus Perez4https://orcid.org/0000-0003-0740-190XDepartment of Psychiatry, University of Cambridge, UKDepartment of Psychiatry, University of Cambridge, UKDepartment of Psychiatry, University of Cambridge; and NIHR Applied Research Collaboration (ARC) East of England, Cambridge, UKDepartment of Psychiatry, University of Cambridge; and NIHR Applied Research Collaboration (ARC) East of England, Cambridge, UKDepartment of Psychiatry, University of Cambridge; NIHR Applied Research Collaboration (ARC) East of England, Cambridge; and Norwich Medical School, University of East Anglia, Norwich, UKBackground Psychotic experiences may emerge in more severe cases of common mental disorders (CMD). Previous work identified that 30% of patients treated by mental health services in primary healthcare, specifically the Improving Access to Psychological Therapies (IAPT) programme in England, reported psychotic experiences, began treatment with more severe CMD and were less likely to reach recovery. Aims To replicate our previous assessment of psychotic experiences in the IAPT programme using a more sensitive threshold and determine its impact on the prevalence of psychotic experience and likelihood of recovery. Additionally, to compare recovery rates between patients with and without psychotic experiences at the end of therapy. Method The Community Assessment of Psychic Experiences (CAPE-P15) with a cut-off of 1.30 was used to determine the prevalence of psychotic experiences. Recovery rates were determined using measures collected in the IAPT programme for depression (PHQ-9) and anxiety (GAD-7). Multi-group growth models estimated improvement trajectories. Results In total, 2042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The prevalence of psychotic experiences was 18% higher when using a lower threshold. The recovery rate for patients with psychotic experiences was lower (36%) than for those without (64%). Despite sharing similar improvement trajectories, the higher initial severity of CMD among patients with psychotic experiences impeded likelihood of recovery. Conclusions As psychotic experiences may be a marker of severity in CMD, the benefits of identifying these in IAPT populations may also apply to patients with milder experiences. Further investigation of the consequential demands on service provision and how this would affect clinical practice is recommended. https://www.cambridge.org/core/product/identifier/S2056472420001209/type/journal_articleAnxietyat-risk mental statecommon mental disorderdepressionpsychotic experiences |
| spellingShingle | Clare Knight Debra Russo Jan Stochl Peter B. Jones Jesus Perez More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider BJPsych Open Anxiety at-risk mental state common mental disorder depression psychotic experiences |
| title | More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider |
| title_full | More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider |
| title_fullStr | More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider |
| title_full_unstemmed | More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider |
| title_short | More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider |
| title_sort | more sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services effect on prevalence and recovery casting the net wider |
| topic | Anxiety at-risk mental state common mental disorder depression psychotic experiences |
| url | https://www.cambridge.org/core/product/identifier/S2056472420001209/type/journal_article |
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