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Linda Smith (2021)
Decolonizing Methodologies
INTRODUCTIONThe validity of diagnostic classification in first episode psychosis (FEP) is of paramount importance to ensure optimized early intervention. This is especially the case for ethnic minority and Indigenous groups, who are subject to disproportionately high rates of psychotic disorders (Gynther et al., 2019; Halvorsrud et al., 2019), as well as structural and individual biases that impact outcomes (Nazroo et al., 2020). Initial diagnosis of a psychotic disorder has broad consumer implications, both in terms of disorder trajectory and service provision. This is particularly relevant for non‐specific time limited diagnoses that do not necessarily fall under the remit of treatment guidelines for FEP (Fusar‐Poli et al., 2022). Despite this, Indigenous groups have been largely marginalized in this area of research, which risks further perpetuating ongoing disparities in outcomes for these populations.Broadly there is strong meta‐analytical evidence for diagnostic stability in early psychosis for schizophrenia and affective spectrum psychoses, using both DSM and ICD criteria (Fusar‐Poli et al., 2016; Heslin et al., 2015). However, non‐specific time limited diagnosis, such as schizophreniform, brief psychotic disorder or psychosis NOS, have been found to be less stable with a high rate shifting towards schizophrenia spectrum psychoses when more compelling symptoms emerge with time (Fusar‐Poli et al., 2016; Heslin et
Early Intervention in Psychiatry – Wiley
Published: Mar 1, 2023
Keywords: diagnosis stability; first episode psychosis; health service use; indigenous
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