Prevalence and predictors of treatment failure, treatment resistance and clozapine use in early-onset psychosis: findings from a historical clinical cohort study in UK

Approximately one third of adults with psychosis have will fail to
respond to their first and second trial of antipsychotic medication. These individuals are at high risk of developing profound and lifelong psychiatric disability. Currently, one in five people who are diagnosed with a psychotic disorder will present with their first episode before age 18 (i.e. early-onset psychosis). To date, no studies have described the demographic and clinical characteristics of adolescents with a first-episode psychotic disorder who fail to respond to successive courses of antipsychotic treatment and meet criteria for treatment failure/resistance.
Dr. Johnny Downs will present preliminary findings from a large historical clinical cohort study in the UK of 315 children and ado- lescents, aged 10 to 17 years, with a first-episode psychotic disorder.
Using anonymised electronic health records, data will be presented on (i) antipsychotic use in this sample, (ii) the prevalence of treatment failure/resistance and (iii) the demographic and clinical factors at first presentation to mental health services, derived from multivariable models, that are significantly associated with adolescent onset psy- chosis and failure/resistance. These findings will aid the identification of adolescents on the pathway to treatment failure/resistance whilst in the first phases of their psychotic disorder. This will be especially valuable to clinicians working within adolescent early onset psychosis services. The study findings have the potential to guide tailored in- terventions in those patients deemed to be at higher risk of developing treatment failure and resistance.