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Despite accumulating evidence of an association between stressful life events and psychosis relapse, the extent to which this is a causal relationship remains unclear. We aimed to examine the association between exposure to, and number of, stressful life events after initial psychosis onset and psychosis relapse.

Antibodies targeting the N-methyl-D-aspartate receptor (NMDAR) have been detected in patients with psychosis. However, studies measuring the IgG subclass in serum have provided variable estimates of prevalence, and it is unclear whether these antibodies are more common in patients than controls. Because these inconsistencies could be due to methodological approaches and patient characteristics, we aimed to investigate the effect of these factors on heterogeneity.

BackgroundThe components of care delivered by Early Intervention in Psychosis (EIP) services vary, but the impact on patient experience is unknown.ObjectiveTo investigate associations between components of care provided by EIP services in England and patient-reported outcomes.Methods2374 patients from EIP services in England were surveyed during the National Clinical Audit of Psychosis. Participants were asked about the care they received, and completed the ‘Patient Global Impressions’ Scale (rating whether their mental health had improved), and ‘Friends and Family Test’ (rating whether they would recommend their service). Information about service structure was obtained from service providers. We analysed associations between outcomes and components of care using multilevel regression.FindingsThe majority of participants were likely to recommend the treatment they had received (89.8%), and felt that their mental health had improved (89.0%). Participants from services where care coordinators had larger case loads were less likely to recommend their care. Participants were more likely to recommend their care if they had been offered cognitive behavioural therapy for psychosis, family therapy or targeted interventions for carers. Participants were more likely to report that their mental health had improved if they had been offered cognitive behavioural therapy for psychosis or targeted interventions for carers.ConclusionsSpecific components of EIP care were associated with improved patient reported outcomes. Psychosocial interventions and carer support may be particularly important in optimising outcomes for patients.Clinical implicationsThese findings emphasise the need for small case load sizes and comprehensive packages of treatment in EIP services.

Previous studies indicate that risk of mortality is higher for patients admitted to acute hospitals at the weekend. Thus, there is a drive to move towards provision of a 7 day health-care service in the UK. However, less is known about variations in clinical outcomes among patients admitted to psychiatric hospitals. We sought to investigate variations in clinical outcomes for patients admitted to a psychiatric hospital at the weekend.