The 21st Century Cures Act mandated that new medication research include patient focused drug development initiatives. The act also recognized CPSSs as integral members of the healthcare team. Inclusion of CPSSs within care teams is associated with reduced hospitalization, increased treatment engagement, and a renewed focus on patient desired outcomes. CPSSs are people with lived experience in navigating complex mental health systems and whose unique perspective helps guide peers on their journey to wellness. In the same manner that CPSS knowledge has improved clinical outcomes, partnering with CPSSs during CNS drug development may provide wellness outcomes in clinical trials that are more meaningful for people with lived experience. To this end, a CPSS Ambassador program was initiated.

Of 85 peer support specialists identified by internet searches, Linked-In, and peer support specialists’ registries, 7 CPSSs met our criteria (i.e., having lived experience of psychosis and being a member of a treatment team) and agreed to be part of our ambassador program. Interactions included 6 monthly virtual meetings and a live roundtable meeting. The objectives of the program were to: 1) understand unmet needs in people with lived experience and identify impediments to effective treatment, 2) learn best practices for discussing medication use to support wellness, 3) identify resources that can help educate people and families with lived experience, and 4) highlight the importance of CPSSs within healthcare teams to optimize treatment outcomes.

This CPSS ambassador program emphasized the need for shared decision making and partnership to forge a positive treatment team alliance. As such, treatment goals should be tailored to patients’ needs (“nothing about me without me”). A major obstacle to effective treatment is the presence of bias or stigma among health care practitioners. Specifically, certain language used by clinicians has the potential to ostracize patients and negatively impact treatment. Medications should be discussed as one pillar of a larger treatment plan and not as a “fix” for symptoms. Educational resources written in layman’s terms are needed to explain treatment algorithms and medication side effects. And finally, CPSSs make a significant contribution to person-focused positive outcomes and are an essential part of the treatment team. CPSSs are a conduit of lived experience and advocate for the individual

The following key outcomes were illuminated because of this work together: CPSS’s are liaisons that facilitate the intersection between the treatment team and people utilizing mental health systems. CPSS’s are critical to successful navigation of the mental health care system and reaching desired outcomes. Best practices for treatment teams are about effective, person-based and stigma free partnerships for positive and patient focused outcomes.

Sumitomo Pharma America (formerly Sunovion Pharmaceuticals Inc)

Diagnostic stability is a controversial issue in first episode psychosis (FEP) due to heterogenous symptoms and unclear affective symptoms. Differencing affective and non-affective psychoses is important as treatment strategies are different. Initial affective symptomatology has low specificity for predicting the subsequent diagnosis of affective psychosis. Sex has proven to be relevant for clinical and functional outcomes but it remains unclear how sex may contribute to diagnosis switch of FEP.

To determine the role of sex in diagnostic stability in a sample of FEP after 1-year follow-up.

Diagnoses of FEP patients from Hospital del Mar of Barcelona were assessed at baseline and 1 year after. Univariate analyses was perfomed for all diagnoses and dichotomic variable (affective/non-affective). Logistic regression model was perfomed to know which variables predict diagnosis switch.

256 patients were enrolled. No differences were found at baseline between completers and non-completers (Table 1). No significant differences between men and women at baseline diagnosis were found, neither all diagnoses (p=0.274) nor the dichotomic variable affective/non-affective (p=0.829) (Table 2AB). Significant differences were found at 1-year follow-up between men and women, for all diagnoses (p=0.043) and the dichotomic variable (p=0.039). Sex was the only variable that predicted diagnosis switch (Figure 1), PANSS, CDSS, YMRS, GAF and cannabis did not.Table 1.

Baseline characteristics of participants

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Sex has proven to be the main predictor of switching initial diagnosis of FEP.

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Psychotic disorders are strongly linked to a higher risk of mandatory hospitalization, often affecting men more, though some studies report the opposite. Recent investigations also show a higher rate of involuntary admissions in younger individuals. Knowledge in this area is still limited despite extensive research.

Analyze whether there is an association between sex and age with involuntary admissions of individuals with psychotic disorders.

Retrospectively, 254 people with psychotic disorders admitted between 2018-2023 to the adult psychiatric inpatient unit at Hospital Universitari Germans Trias i Pujol were selected, collecting their nature of admission, sex, age, and discharge diagnosis. Comparisons between voluntary and involuntary admissions, with respect to sex and age variables, were conducted using independent sample t-tests, Mann-Whitney U tests, Fisher’s exact test, and chi-square tests. A logistic regression model was used to identify variables significantly associated with mandatory admission.

In both the male and female groups, there were no statistically significant differences in terms of the mean age at admission (p = 0.162) or the nature of admission (p = 0.586) (Table 1). When analyzing the voluntary nature of admission based on age and sex, statistically significant differences were only found in the female group (p = 0.01), resulting in a 9.18 year age difference among those admitted voluntarily (Table 2). The model that best predicted the probability of involuntary admission in individuals with psychotic disorders included the sex variable (OR = 4.88) and the interaction between sex and age (OR = 0.97) (Table 3).Table 1:

Differences between sex regarding voluntariness of patients with psychotic disorders.

Young women with psychotic disorders face a higher risk of involuntary admissions, emphasizing the need for gender-specific strategies to improve care of these patients.

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