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Aim: Vitamin D deficiency is prevalent in people with established psychotic disorders, but less is known about vitamin D levels in people with first‐episode psychosis (FEP). This study aimed to determine the prevalence of vitamin D deficiency in people with FEP and identify the factors associated with vitamin D status. Methods: This was a prospective cohort study nested within a randomized controlled trial, which included 37 young people with an FEP with minimal antipsychotic medication exposure. Results: Twenty‐four percent of participants were vitamin D deficient, and a further 30% were vitamin D insufficient. There was no association between vitamin D and demographic factors or clinical symptoms (positive, negative, general psychopathology and depressive symptoms) or cognition and functioning. However, vitamin D levels were associated with season of sampling. Conclusions: Considering the longer‐term adverse effects associated with vitamin D deficiency, it is warranted to ensure this clinical population receives supplementation if indicated. [ABSTRACT FROM AUTHOR]

Background Digital interventions have potential applications in promoting long-term recovery and improving outcomes in first-episode psychosis (FEP). This study aimed to evaluate the cost-effectiveness of Horyzons, a novel online social therapy to support young people aged 16–27 years following discharge from FEP services, compared with treatment as usual (TAU) from a healthcare sector and a societal perspective. Study design A cost-effectiveness analysis (CEA), based on the change in social functioning, and a cost-utility analysis (CUA) using quality-adjusted life years were undertaken alongside a randomized controlled trial. Intervention costs were determined from study records; resources used by patients were collected from a resource-use questionnaire and administrative data. Mean costs and outcomes were compared at 18 months and incremental cost-effectiveness ratios were calculated. Uncertainty analysis using bootstrapping and sensitivity analyses was conducted. Study results The sample included 170 participants: Horyzons intervention group (n = 86) and TAU (n = 84). Total costs were significantly lower in the Horyzons group compared with TAU from both the healthcare sector (–AU$4789.59; P <.001) and the societal perspective (–AU$5131.14; P <.001). In the CEA, Horyzons was dominant, meaning it was less costly and resulted in better social functioning. In the CUA, the Horyzons intervention resulted in fewer costs but also yielded fewer QALYs. However, group differences in outcomes were not statistically significant. When young people engaged more with the platform, costs were shown to decrease and outcomes improved. Conclusions The Horyzons intervention offers a cost-effective approach for improving social functioning in young people with FEP after discharge from early intervention services. [ABSTRACT FROM AUTHOR]

Objectives: Compulsory mental health care includes compulsory hospitalisation and outpatient commitment with medication treatment without consent. Uncertain evidence of the effects of compulsory care contributes to large geographical variations and a controversy on its use. Some argue that compulsion can rarely be justified and should be reduced to an absolute minimum, while others claim compulsion can more frequently be justified. The limited evidence base has contributed to variations in care that raise issues about the quality/appropriateness of care as well as ethical concerns. To address the question whether compulsory mental health care results in superior, worse or equivalent outcomes for patients, this project will utilise registry‐based longitudinal data to examine the effect of compulsory inpatient and outpatient care on multiple outcomes, including suicide and overall mortality; emergency care/injuries; crime and victimisation; and participation in the labour force and welfare dependency. Methods: By using the natural variation in health providers' preference for compulsory care as a source of quasi‐randomisation we will estimate causal effects of compulsory care on short‐ and long‐term trajectories. Conclusions: This project will provide valuable insights for service providers and policy makers in facilitating high quality clinical care pathways for a high risk population group. [ABSTRACT FROM AUTHOR]

Aim: The sexual health of adults with schizophrenia is poorer than the general population; however, less is known about young people experiencing a first episode of psychosis (FEP). The aim of this study was to explore the high‐risk sexual behaviours and sexual well‐being indicators of a cohort of young people with FEP. Methods: Data collected from young people (15‐24 years) with FEP attending the EPPIC service in Melbourne and participating in a physical health intervention were analysed. Baseline trial data collected on sexual health and high‐risk behaviours, psychiatric symptomology, functioning, and substance use are presented by gender. Associations between symptomology and functioning with sexual behaviour are explored. Results: A total of 69 young people were included in this study; mean age was 19.6 years (SD±2.8), 53.6% were male, 59.6% identified as heterosexual, and 21.7% were currently in a relationship. Within the cohort, 78.3% had ever been sexually active. Of these, 44.2% consistently used a condom at last sex act and 35.7% used barrier contraception consistently, 22.5% had previously been pregnant, and 18.6% had tested positive for an STI. Finally, young people were more likely to have been sexually active if they were currently using substances. Conclusions: These findings suggest that high rates of high‐risk sexual behaviour remain an issue for young people experiencing a first episode of psychosis. Promoting sexual well‐being and communication skills between sexual partners should be targeted to ensure that high‐risk sexual health outcomes are mitigated as early as possible. [ABSTRACT FROM AUTHOR]

The role of the Individual Placement and Support (IPS) employment specialist is a new type of occupation within mental healthcare. High turnover among employment specialists necessitates improvement in their recruitment and retention. One element that impacts retention is job satisfaction. We assessed the personality of 38 employment specialists (Big 5 Inventory‐2) and measured job satisfaction over three time periods. Compared to norm data, employment specialists were significantly higher on Extraversion (ΔT = 8.0, CI: 5.59–10.42), Agreeableness (ΔT = 7.8, CI: 5.56–10.12), Conscientiousness (ΔT = 3.3, CI: 0.8–5.84), Open‐mindedness (ΔT = 3.5, CI: 0.97–6.07), while lower on Negative emotionality (ΔT = −3.5, CI: −6.5 to −0.42). Extraversion had a substantial longitudinal positive effect on job satisfaction (β at T1 = 0.39; CI: 0.10–0.73) (β at T2 = 0.40; CI: 0.03–0.80), while Negative emotionality – a substantial negative effect (β at T1 = −0.60; CI: −0.90 to −0.30) (β at T2 = −0.50; CI: −0.90 to −0.12). Male gender was significantly associated with higher job satisfaction at the time point 1 (β = −0.46; CI: −0.80 to −0.14). Age, length of employment in the role, Agreeableness, Conscientiousness and Open‐mindedness were not found to have substantial significant effects on job satisfaction of employment specialists. Recruiting employment specialists who score high on Extraversion and low on Negative emotionality may be a good fit for the role and job satisfaction. [ABSTRACT FROM AUTHOR]