Disagreement between Service-users and Clinicians Assessment of Physical Health during Early Psychosis

Aims: Physical illnesses account for the majority of excess deaths following psychosis; access to care and treatment is inequitable and schizophrenia has now been dubbed the life-shortening disease. We compared service-users and clinician’s perspectives of their physical health assuming that one of the fundamental issues in prompting screening and treatment is the view that health is poor.

Methods: Data comprising sample characteristics, diagnosis, symptoms, insight, antecedents to psychosis and physical health perspectives were obtained prospectively as part of a larger epidemiological study of first-episode psychosis. We compared physical health perspectives between service-users and clinicians and examined clinical correlates.

Results: Contrary to our expectations, we found that service-users reported poorer physical health over time than clinicians did.

Conclusion: Reconciling service-users and clinician’s views of physical health may be an important step towards collaborative care and improving access to better quality healthcare for serious mental illness.