Predictors of Persistent Symptoms in People in Coordinated Specialty Care Services for Early Psychosis in New York State

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Amplify OnTrackNY publication summaries summarize peer-reviewed publications focused on quality improvement or research conducted to help us learn & improve the program.

Study snapshot

Understanding more about symptoms that persist during treatment and factors associated with continuing symptoms could help teams offer more tailored services to participants that may benefit from more than usual care.¹  

This study asks:

1. How common are continuing symptoms in OnTrackNY participants in their first year of the program?
2. What factors are associated with symptoms continuing despite treatment?

This study is based on 1129 diverse participants in their first year at OnTrackNY. Information on demographic characteristics, family and living situation, medication use, and pathways to care are collected by teams at baseline and every three months.

Study findings

Finding 1. Authors created three symptom groups based on severity of symptoms reported during the first year on the program:

• Persistent: 12% reported more severe symptoms
• Intermittent: 21% reported improvement in symptoms, but reported severe symptoms at least once during the period
• Improving to moderate: 67% of participants reported improved symptoms

Finding 2. Factors associated with more severe symptoms are:

• Homlessness
• Not having health insurance
• Not taking medications as prescribed
• Receiving a schizophrenia diagnosis on the first assessment
• Longer time experiencing symptoms before starting treatment

Figure 1: What are the main symptom scores by symptom group?

The three graphs represent each symptom group. Within each group, the figure shows trends in individual-level scores on a symptom scale (y-axis) in time (x-axis).

Final thoughts

Despite treatment, severe symptoms may persist in OnTrackNY participants because of economic barriers, treatment delays, and lack of stability. These findings highlight the need for earlier access to treatment and more alternatives to medications. 

Still more studies are needed to further explore factors associated with continuing symptoms. 

References

1. Zambrano J, Scodes J, Marino LA, Nossel I, Bello I, Ngo H, Dixon LB, van der Ven E. Predictors of Persistent Symptoms in People in Coordinated Specialty Care Services for Early Psychosis in New York State. Psychiatric Services. 2022 Jan 1;73(1):92-95. doi: 10.1176/appi.ps.202000821. Epub 2021 Jun 2. PMID: 34074148; PMCID: PMC8636503.

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