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COVID-19 is a very stressful experience for people with FEP and changed the work routine of the mental health services they have used.
Objectives
In this work, we aim to explore how the restrictions influenced the out-patient visits and rehospitalization rates.
Methods
The Latvian Early intervention programme (Berze et al.,2019) for patients with FEP had started on 1st January, 2019. The 1st group of patients (n=28) finished the programme on 31st December, 2019. The 2nd group of patients were enrolled in programme on 1st January, 2020 (n=12). When on 12th of March in Latvia health care restriction started due the COVID-19 situation, we were forced to change our structure of LAT-EIP.
Results
The average patient age of patients was 29.9 (SD±7.1) years in the 1st group, in 2nd group average age is 26.2 (SD±5.9) accordingly in years. In the 1st group 60.7% of patients visited the psychiatrist 6-10 times vs 8.33% in 2nd group, in the 1st group 32.1 % of patients had 2-5 visits with psychiatrist vs 75% in 2nd group. There were 72 family sessions in 1st group, whereas in 2nd group the family sessions were excluded. During the programme 7% (n=2) of patients in the 1st group were rehospitalized vs 25% (n=3).
Conclusions
The structure of LAT-EIP had change at the time of COVID-19 restrictions, unfortunately our work lack the statistical power. From the descriptive statistics, we can speculate that the rehospitalization rate is higher because of the lack of regular contact with psychiatrist and the lack of psychoeducation with families.
Increased physical morbidity in patients with schizophrenia spectrum disorders (SSDs) is well documented. However, much less is known about the association between somatic comorbidities and psychosis treatment outcomes.
Subjects and methods:
This cross-sectional study, nested within the larger frame of a prospective cohort study, was done in 2016 at Psychiatric Hospital Sveti Ivan, Zagreb, Croatia. Data were collected on a consecutive sample of 301 patients diagnosed with schizophrenia spectrum disorders who achieved a stable therapeutic dosage. Key outcome was the number of psychiatric rehospitalizations since diagnosis of the primary psychiatric illness. Predictors were number of physical and psychiatric comorbidities. By robust regression, we controlled different clinical, sociodemographic, and lifestyle confounding factors.
Results:
The number of chronic somatic comorbidities was statistically significantly associated with a larger number of psychiatric rehospitalizations, even after the adjustment for number of psychiatric comorbidities and large number of other clinical, sociodemographic, and lifestyle variables.
Conclusions:
Chronic somatic comorbidities are associated with higher rates of psychiatric rehospitalization independently of psychiatric comorbidities and other clinical, sociodemographic, and lifestyle factors. Therefore, to treat psychosis effectively, it may be necessary to treat chronic somatic comorbidities promptly and adequately. Chronic somatic comorbidities should be considered equally important as the SSD, and should be brought to the forefront of psychiatric treatment and research with the SSD as one entity. The integrative approach should be the imperative in clinical practice.
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