A descriptive study of 'non-cases' and referral rates to an early intervention for psychosis service

Aim: Despite there being approximately 200 early intervention services for psychosis worldwide, little is known about the referral rates to these services, the diagnoses and needs of individuals found not to have a first episode of psychosis (FEP). Firstly, we aimed to describe the diagnoses for individuals who were found not to have a FEP (non-cases) following an assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID). We then aimed to examine the referral rates of cases and non-cases to an early intervention service. Methods: All individuals referred to the early intervention service underwent a clinical assessment using the SCID. Results: In a 4-year period, there were 632 referrals to the early intervention service for psychosis, and of these, 53% (n=338) were found to have a FEP, 5% (n=34) were found to have an at-risk mental state for psychosis and 41% (n=260) were found to be 'non-cases'. This represents a ratio of 1.9:1 of referrals to cases, or approximately 2:1. Of the non-cases, 27% (n=62) satisfied criteria for a mood disorder, with major depressive disorder the commonest diagnosis. A further 18% (n=42) of non-cases satisfied criteria for an anxiety disorder and nearly half of these were diagnosed with social phobia. The ratio of referrals to cases was not consistent over time and rose from 1.3:1 in the first year to 2:1 in the fourth year. Conclusion: A large proportion of individuals referred to an early intervention for psychosis service were found not to have psychotic disorder, however they still have significant needs regarding their mental health. © 2012 Blackwell Publishing Asia Pty Ltd.