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Aims: The aims of this study were to examine the prevalence and severity of aggression in patients with first-episode psychosis and to identify the association between aggression and sociodemographic and clinical factors. Methods: Consecutive patients with first-episode psychosis admitted to the Early Psychosis Intervention Programme, Singapore, were assessed for a history of aggressive acts. Diagnosis was confirmed using the Structured Clinical Interview for DSM-IV and psychopathology was assessed using PANSS. Results: Of the 146 patients, 63.0% had no history of aggressive acts, 13.7% demonstrated severe aggression (defined as weapon use, sexual assault or victim injury) and 23.3% had lesser aggression (all other acts of aggression). Patients with aggression had a significantly longer duration of untreated psychosis (DUP) than those with no history of aggression (p = .01). The mean total PANSS scores did not differ significantly among the three groups. However, the General Psychopathology scores and the scores for 'hostility', 'poor impulse control', 'lack of insight and judgement' and 'somatic concern' were all significantly elevated in patients with aggression (p < .05). Conclusion: The significant association between aggression and longer DUP once again reiterates the need for early detection and effective management of first-episode psychosis. Key words: aggression, psychosis, psychopathology

Aim: Early intervention programmes for first episode psychosis (FEP) aim to reduce the duration of untreated psychosis (DUP) and improve functional outcomes. The sustained maintenance of improved outcomes depends largely on patients' adherence to prescribed treatment. This paper examines the prevalence of non‐adherence in a cohort of patients with FEP and the sociodemographic and clinical factors associated with non‐adherent behaviour. Methods: The sample included consecutive patients accepted from 2007 to 2012 into the Early Psychosis Intervention Programme (EPIP) in Singapore. Sociodemographic variables as well as DUP, insight, severity of psychopathology and clinical diagnoses were collected. Patients were assessed at baseline and 1 year with the PANSS and Global Assessment of Functioning Scale (GAF). Medication adherence was grouped into 3 categories: no‐adherence, partial adherence and regular adherence. Results: Of the 445 patients included, 51% were male with a mean age of 26.3 years, 74.6% had schizophrenia spectrum and delusional disorders, 14% had affective psychosis and 11.3% had brief psychotic disorder or psychotic disorder not otherwise specified. At 1 year follow up, 65.5% reported regular adherence, 18.7% were partially adherent and 15.8% were non‐adherent. Non‐adherence was correlated with male gender, living alone and having poorer judgement and insight. Partial adherence was associated with Malay ethnicity and having undergone national service. Conclusion: Medication adherence is prevalent in FEP and associated with a variety of factors. This study supports the use of culturally appropriate interventions in addressing barriers to adherence. Further studies would need to be done to address specific factors affecting adherence outcomes. [ABSTRACT FROM AUTHOR]

Aims This study aimed to identify the gender differences among multi-ethnic, Asian patients with first-episode psychosis attending the Early Psychosis Intervention Programme ( EPIP) in Singapore. Methods Data for this study were derived from 533 (258 female, 275 male) patients aged 16-41 years old in the EPIP database. Socio-demographic data, Positive and Negative Syndrome Scale for schizophrenia ( PANSS) and Global Assessment of Functioning ( GAF) scores at baseline, 3 months, 6 months and 1 year were obtained. Results Significant gender differences were identified in terms of age, marital status, referral source, PANSS scores, GAF scores, remission and recovery over 1 year in the cohort. At service entry, female participants were older, more likely to be married and more likely to be referred from general practitioner/polyclinics ( P < 0.0001). They showed better improvement over 1 year in PANSS positive, PANSS total, GAF disability and GAF total scores. Conclusions Overall, female participants in this sample show better improvement than male participants. They showed a better course of illness over 1 year with one-third (33.3%) of female participants achieving recovery compared with approximately a quarter (23.6%) of male participants. [ABSTRACT FROM AUTHOR]

Aims The aim of the current study was to create a typology of patients with first-episode psychosis based on sociodemographic and clinical characteristics, service use and outcomes using cluster analysis. Methods Data from all respondents who were accepted into the Early Psychosis Intervention Programme ( EPIP), Singapore from 2007 to 2011 were analysed. A two-step clustering method was carried out to classify the patients into distinct clusters. Results Two clusters were identified. Cluster 1 comprised largely of younger people with mean age of 25.5 (6.0) years at treatment contact, who were predominantly male (55.3%), single (98.3%) and living with parents (86.3%). Cluster 1 had a higher proportion of people diagnosed with the schizophrenia spectrum disorder (71.4%) and with a positive family history of psychiatric illness. Patients in cluster 2 were generally older with a mean age of 33.6 (4.7) years and the majority were women (74.2%). Cluster 1 had people with higher Positive and Negative Syndrome Scale ( PANSS) scores at baseline as compared with cluster 2. After a 1-year follow up, their scores were still poorer than their counterparts in cluster 2, especially for PANSS negative score. The functioning level of people in cluster 1 showed less improvement than the people in cluster 2 after a year of treatment. Conclusions There is a compelling need to develop new therapies and intensively treat young people presenting with psychosis as this group tends to have poorer outcomes even after 1 year of treatment. [ABSTRACT FROM AUTHOR]